Vascular Testing, DVT, And the Lot

One of the many issues sonographers have to deal with is the source of an embolism.  Currently, when a patient has a CVA (Stroke) or RIND (resolving intermittent neurologic defect), and echocardiogram and a carotid Doppler are ordered.  This post does not deal with these issues, rather I am posting something far more reaching.  Guidelines for ordering vascular testing.  Often times we are called up at 3am for a DVT study.  Most  people do not understand that DVT does not cause a stroke.  It may cause a pulmonary embolism.  Patients who suffer from atrial fibrillation have a high incidence of stroke.  This is why they are commonly prescribed medications that reduce the incidence of clot formation in the left atrium of the heart.  I have no issue with this therapy.  I think it is common sense.  As an echocardiographer, I must always be vigilant for masses in the heart.  But here is something I came across at Sonoworld.  Blessings to you folk's.

Applicable to patients with venous disease and severe chronic kidney disease

A new report issued today by the American College of Cardiology (ACC) and developed in collaboration with 10 other leading professional societies provides detailed criteria to help clinicians optimize the appropriate use of certain noninvasive vascular tests when caring for patients with known or suspected disorders of the venous (veins) system. Also included are first-time recommendations for when and how to use these tests to plan for or evaluate dialysis access placement.

"Vascular lab testing is central to the care of patients with most peripheral vascular disorders, but appropriate use criteria for these [technologies] have lagged behind those for cardiac testing," said Heather Gornik, MD, FACC, cardiologist and vascular medicine specialist at the Cleveland Clinic and chair of the writing committee. "With this report, we now have multidisciplinary criteria upon which we can start maximizing the quality and appropriateness of what we do in the vascular lab every day."

Vascular testing is often used to help evaluate possible venous thromboembolism, which is the third most common cardiovascular disease, after coronary disease and stroke, and includes deep vein thrombosis (DVT) as well as pulmonary embolism (PE). These conditions can be fatal and result in hospitalizations and long-term complications. Therefore, identifying the best methods for detecting clots in the veins early on can be lifesaving, Dr. Gornik said. "But we must know that we are ordering the right test for the right reasons," she added.

Here is the link  Thanks Sonoworld

This post has been crosslinked to Echocardiography world

http://www.eurekalert.org/pub_releases/2013-07/acoc-nrh071913.phphttp://www.eurekalert.org/pub_releases/2013-07/acoc-nrh071913.php