The USC Center for Vascular Care provides management and oversight of three noninvasive vascular laboratories; USC University Hospital in Los Angeles, Huntington Memorial Hospital in Pasadena, and LAC+USC Medical Center.

The Noninvasive Vascular Laboratory performs sophisticated noninvasive cervical, cerebral, peripheral and abdominal vascular studies. The goal is to assist physicians in making a timely clinical diagnosis of venous or arterial circulatory conditions, while assisting them to determine the need for more complex diagnostic or therapeutic procedures.

Benefits
Noninvasive vascular evaluations offer a number of advantages. These sophisticated tests are painless and can document the presence, location and severity of arterial and venous vascular disease. In addition, the noninvasive nature of the exam greatly reduces patient risk and enhances patient comfort when compared to invasive diagnostic procedures. These tests are also cost-effective, an important consideration in today's health care environment.

Service-Oriented Approach
The Noninvasive Vascular Laboratory takes a "service-oriented" approach to physicians and patients. This is exemplified by:

• Rapid Report Turnaround Time
  Preliminary reports are immediately communicated to the referring physician by either telephone or fax. Final reports, interpreted by our physician panel, are faxed to the referring physician's office within 48-72 hours of the study. Our physicians are available for consultation regarding a study at any time.

• Sensitivity to Patient Needs
  Each patient referred to the Noninvasive Vascular Laboratory is treated as an individual with specific special needs. Vascular technologists obtain a complete problem-focused history, thoroughly explain the procedure, and help the patient relax by carefully describing the test as it is being performed.

• Comprehensive Evaluation
  Each comprehensive vascular evaluation includes a complete problem-focused history, performance of the test with hard copy and/or video recording of the data, physician-interpreted results, and readily available reports.

State-of-the-Art Technology
The Noninvasive Vascular Laboratory features the latest technology available in the field. This includes:

• Direct Studies
  Colorflow duplex ultrasonography is utilized to evaluate the arterial and venous systems. This technology combines three ultrasound modalities:
  1. Two-dimensional B-mode ultrasound imaging of tissue in gray scale provides anatomic information about the vessels of interest. The presence or absence of therosclerotic plaque or thrombus is determined using this modality.

  2. Doppler ultrasound provides physiologic information about blood flow in the vessel. Using this modality, a Doppler velocity spectral analysis is obtained, which can determine whether plaque or thrombus is hemodynamically significant and compromising blood flow.

  3. Colorflow ultrasound provides the ability to quickly visualize blood flow and demonstrate the degree of vessel obstruction.

• Indirect Studies
  Indirect studies also play a key role in noninvasive vascular evaluations. These tests include digit plethysmographic analysis for evaluation of perfusion, spectral and/or analog waveform analysis for characterization of the Doppler velocity signals, segmental Doppler systolic pressures, partial transcutaneous oxygen pressure measurements, and air plethysmography (APG), which quantitatively evaluates venous outflow obstruction and valvular incompetence.

• Special Applications
  Certain conditions require special studies, and the Noninvasive Vascular Laboratory is equipped to perform these tests. For example, in addition to the evaluation of the cervical carotid arteries, physicians may separately order a Transcranial Doppler (TCD) exam for specific intracranial cerebral vascular indications. The TCD utilizes Doppler velocity spectral analysis to assess intracranial vessels of the anterior, posterior and ophthalmic circulations.

  Certain peripheral arterial conditions require special testing, such as provocative exams, evaluation of hemodialysis grafts and the penile circulatory system.

• Personalized Programs
  In addition to being patient and service oriented, the Noninvasive Vascular Laboratory is education oriented as well, with special in-service programs for community physicians and their staff. These sessions delineate the different diagnostic techniques used in the Vascular Lab, describe the importance and indications for each test, and explain the various disease processes involved.

For More Information
The Noninvasive Vascular Laboratory at USC University Hospital is open from 7:00 a.m. to 7:00 p.m., Monday through Friday. To obtain a study an appointment is necessary, but same-day accommodations are made possible for the out-of-town patient and those requiring an urgent study. For more information or patient referral assistance, please contact the Noninvasive Vascular Laboratory at USC University Hospital at (323) 442-8499.

The noninvasive vascular laboratory at Huntington Memorial Hospital is open from 7:00 a.m. to 7:00 p.m., Monday through Friday. For more information or patient referral assistance, please contact the Noninvasive Vascular Laboratory at Huntington Memorial Hospital at (626) 397-2216.

Common Indications for Studies

CEREBROVASCULAR

• Transient ischemic attack (TIA)
• Stroke
• Carotid bruit
• Non-hemispheric cerebral ischemic symptoms
• Atypical CNS symptoms
• Vague symptoms of light-headedness, dizziness, or syncope
• Prior to heart or major surgeries, in selected cases
• Follow-up of carotid stenosis
• Post-surgical evaluation for carotid re-stenosis
• Question of carotid aneurysm
• Subclavian steal
• Vertebral occlusive disease
• Vertebral basilar symptoms

ABDOMINAL VESSELS

• Abdominal bruit
• Ischemic nephropathy
• Renovascular hypertension
• Mesenteric ischemia
• Abdominal aortic aneurysm
• Aorto-iliac occlusive disease
• Iliac vein or caval thrombosis
• Follow-up of aortic, renal mesenteric, or iliac stenosis
• Post-surgical evaluation for aortic, renal, mesenteric,or iliac re-stenosis
• Post-surgical evaluation of aortic, renal or mesenteric grafts
• Follow up on renal or iliac angioplasty/stent procedures

PERIPHERAL VENOUS

• Suspected deep venous thrombosis or superficial phlebitis - lower or upper extremities
• Follow-up during and after anti-coagulant therapy
• Observation of high-risk patient groups for development of deep venous thrombosis
• Valvular incompetence/reflux in post-thrombotic syndrome
• Varicose veins
• Vein mapping for coronary or peripheral arterial reconstruction

PERIPHERAL ARTERIAL

• Leg pain of questionable etiology
• Evaluation of degree of claudication, if present
• Rest pain - differentiation between diabetic neuropathy versus ischemia
• Evaluation of medical management
• Non-healing foot or toe lesions
• Trauma to peripheral artery
• Weak or absent peripheral pulses
• Evaluation of upper arterial insufficiency
• Peripheral aneurysms(femoral, popliteal)
• Bypass graft follow-up
• Vasospastic disorders
• Impotence evaluation