Vascular sonography is customarily known to be non-invasive and consists of taking ultrasound images of the vascular system – the blood vessels, peripheral to the heart, streaming throughout the entire body. Another term for vascular imagining or ultrasounds is angiographic imaging.
On the other hand, interventional ultrasound is invasive as it involves inserting an imaging device inside the body. Interventional techniques used in concert with imaging or ultrasound capabilities are becoming more prevalent and increasingly effective. “One of its most versatile features continues to be the capability to visualize, in real time, a handheld needle passing through layers of muscles, fat and organs on its way to a target – decided by you – deep inside the body,” describes the European Federation of Societies for Ultrasound in Medicine and Biology on interventional sonography.
Specific to the vascular system, there is “Intravascular Ultrasound” or IVUS, which is another way to describe “Vascular Interventional Sonography”. A small ultrasound device is attached to a catheter which is inserted inside a patient’s body to provide a three-dimensional, cross-sectional view inside the blood vessels. IVUS is most commonly used to examine inside a coronary artery during an angiogram. The procedure is used for diagnostic purposes, such as assessing the level of narrowing (stenosis) of the arterial walls or the amount of plaque build-up inside the artery. Intravascular ultrasound procedures may also be therapeutic, such as being incorporated during an angioplasty when it comes to inserting stents inside the arteries.
The ARDMS (American Registry for Diagnostic Medical Sonography) offer a certification exam in the area of Vascular Technology (to become a Registered Vascular Technologist). To be eligible to write this certification exam, you must hold a relevant ultrasound or invasive vascular degree and/or experience in a related clinical setting. Practicing physicians can also add to their credentials by sitting for ARDMS’ Physicians’ Vascular Interpretation Exam. Specialization in vascular interventional sonography is often coupled with invasive diagnostic and therapeutic procedures associated with the heart, i.e. invasive cardiovascular technology. (Note that more courses/fellowships in this specialty seem to be available to students enrolled in medical school versus those who are enrolled in a diagnostic medical sonography/ultrasound program. Talk to the head of the ultrasound department before enrolling in a program to find out if the prospective school offers interventional vascular clinicals).
Since vascular interventional sonography is invasive, special care must be taken to sterilize all instruments and equipment that are utilized to prevent contamination leading to infection. For performing an intravascular ultrasound, the sonographer or physician employs an ultrasound probe and a guide wire which are inserted into a catheter. Sound waves from the ultrasound probe are converted into images which show up on a computer monitor.
Cardio and vascular interventional ultrasounds are performed on patients that potentially have a range of diseases, including such as femoral, renal, carotid, iliac and coronary artery diseases. These diseases are particularly common among the elderly population.