Techniques in Vascular and Interventional Radiology最新文献

Adhesive capsulitis (AC) develops spontaneously without a known cause and is a common cause of painful shoulder. The natural history of AC can last until 36 months and it is classically considered a self-limiting entity, however there is a high rate of refractory cases to conventional treatment with residual deficits during years. There is no consensus on the therapeutic guidelines to be followed in patients with AC. Several authors have pointed out the relevance of hypervascularization of the capsule in the pathophysiology of AC, that is why the objective of transarterial embolization (TAE) is to decrease the abnormal vascularization responsible for the inflammatory-fibrotic state that occurs in AC. TAE has now emerged as a therapeutic option in refractory patients. We describe the most important technical aspects of TAE and review the current literature on arterial embolization as a treatment for AC.

The vascular lab (VL) is instrumental in diagnosing vascular diseases such as renal artery stenosis and mesenteric ischemia or following a patient after transjugular intrahepatic portal systemic shunt (TIPS) creation. This article discusses indications, protocol, and diagnostic criteria for abdominal vascular ultrasound. The vascular lab can be used to investigate pathology in the abdomen either as a preliminary screening tool to evaluate for a pathology such as mesenteric artery stenosis in a patient with food fear and weight loss, renal artery stenosis in a patient with refractory hypertension or renal failure, or as a diagnostic tool in follow up after a patient has undergone a transjugular intrahepatic portal systemic shunt (TIPS) for portal hypertension. The technical success of duplex ultrasonography of the abdomen can be compromised by respiratory motion, obesity, and intestinal gas. Therefore, duplex scanning is performed in the fasting state particularly in elective outpatient cases. In emergent cases when pathology such as acute mesenteric ischemia is suspected evaluation with CT angiography may be best.

Personnel and department accreditation are means by which institutions can evaluate, demonstrate, and maintain the highest level of patient care. In this article, we will discuss the certification and the resources for physicians (RPVI) and technologists (RVT) who provide care to patients in the vascular lab (VL) as well as information about certification by the two accrediting bodies – the Intersocietal Accreditation Commission (IAC) and the American College of Radiology (ACR) – that accredit VLs. Noninvasive vascular testing provides timely delivered valuable information to healthcare providers. Accreditation recognizes quality vascular testing services, but also facilitates a process of education and the quality assurance to improve the overall quality of vascular labs (VL).

A vascular laboratory (VL) can be defined as a place where physicians and technologists have a commitment to perform and interpret non-invasive testing with objective techniques that are most appropriate to the facility and the skills of the laboratory personnel. It provides the entry point for many patients as well as being the sight for diagnosis and follow up for patients with vascular disease for Interventional Radiologists (IRs). VLs may be run by a multi-specialty service, may be hospital-based, or may be private practice-based providing more of a concierge service. Resident education in the VL is essential and allows IRs to function on equal footing with other medical colleagues who see and treat similar patients from an early stage and throughout an IR's career. In this article we will discuss the IRs imperative connection to the VL.

Billing, coding, reimbursement, costs, and marketing for a vascular lab (VL) may seem daunting. This article simplifies monetary aspects of setting up and running a successful VL so that they are less complex. In setting up the vascular lab (VL), there is a lot to consider regarding money. Many are not savvy in this respect; however key knowledge is needed to start up a successful VL. This article aims to simply describe some factors and ideas regarding money and the promotion to increase financial return.

The advantages of the vascular lab (VL) are a specialized knowledgeable team and a dedicated equipment which is transferrable to the procedure room to facilitate the procedure and gather information about the procedure endpoints. In this article, Registered Vascular Technologists (RVT) from various institutions discuss the basic and the complex ways the VL can be used inside a procedure room. The advantages of the vascular lab (VL) are a specialized knowledgeable team and dedicated equipment which is transferrable to the procedure room to facilitate the procedure and gather information about procedure endpoints. Such expertise may improve imaging guided access, enable complicated lesion crossing, and provide information about the success of the procedure. Below are the reports from practicing registered vascular technologists at the forefront of patient vascular care within institutions that have adopted the mobile intraprocedural VL idea in basic and complex real-world ways.

A vascular lab procedure culminates in a diagnostic report that is a combination of the data generated on the vascular lab equipment, physician interpretations, and recommendations. The transcription process can be error prone and inefficient. Computerized capture of data from the equipment and transmission into a reporting system is the definition of “automation” in this article. In this article, we describe an organized approach to collecting data generated on vascular lab equipment and delivering to reporting systems to decrease error and improve efficiency.

The vascular lab (VL) is a powerful tool in diagnosing arterial disease, including peripheral and aortic disease, which is cornerstone of many VLs. This article discusses the indications, protocol, and diagnostic criteria of noninvasive testing for peripheral arterial disease and contrast enhanced ultrasound after endovascular repair of aortic aneurysm.

The vascular lab (VL) provides unequalled information regarding venous disease especially in the depiction and characterization of venous waveforms. This article provides the indications, protocol, and diagnostic criteria for peripheral and central venous disease and venous mapping. Venous evaluation is one of the most common studies performed at vascular labs (VL). Patient may present with swelling for evaluation of thrombosis, central obstruction, or venous insufficiency, or may need preoperative planning prior to a bypass or dialysis access creation. It is my hope that the added value a VL brings to the sonographic evaluation of veins, beyond the compressibility of the veins, is the utmost respect and attention to the depiction and characterization of the venous waveform.