Indications and uses of the noninvasive vascular laboratory: extremity or visceral arterial evaluation.

The tests in the noninvasive vascular laboratory are highly accurate for assessing the patient with extremity or visceral artery disease. Once the location and severity of any arterial disease in patients with claudication or critical limb ischemia (ie, gangrene, ulceration, rest pain) is determined by the noninvasive tests, a treatment plan can be developed and then discussed with the patient, with consent obtained prior to any invasive procedure. The presence of hypertension from renal artery stenosis, or chronic mesenteric ischemia from visceral artery stenosis, can be evaluated by duplex scanning, without the need for invasive contrast angiography. Monitoring the function of revascularization procedures, such as angioplasty or bypass grafts, is also possible and significantly improves long-term patency and organ or limb salvage by identifying the need for elective revision of failing reconstructions prior to thrombosis. Noninvasive vascular laboratory tests are the initial procedures of choice for the evaluation of patients with extremity or visceral arterial disease.