Indications and uses of the noninvasive vascular laboratory: cerebrovascular and venous evaluation

Noninvasive vascular laboratory tests are highly accurate in diagnosing cerebrovascular arterial and extremity venous disease. These tests can also locate and grade the severity of the disease. Noninvasive studies are preferable to invasive angiographic procedures for the initial evaluation of patients who may have carotid artery disease, deep venous thrombosis, or venous valvular insufficiency. Arteriography of the extracranial cerebrovascular arteries should be used only for operative candidates who have severe disease of the carotid artery as determined by noninvasive studies. Venography is indicated in the few cases in which tibial vein thrombosis cannot be excluded by the noninvasive tests, or in patients undergoing evaluation for venous surgery (valvuloplasty or valve transplant).