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Registered Vascular Ultrasound Specialist

RVUS - Registered Vascular Ultrasound Specialist

RVUS-Registered Vascular Ultrasound Specialist is a healthcare professional that evaluates and describes sonographic appearance of the blood organ vessels anatomy and physiology with the assistance of ultrasond technology. Our certification exam both clinical and theory competencies, follow suggested but not limited protocols from standard institutions who present guidelines for the performance of these studies.

These protocols are an educational tool designed to assist vascular ultrasound graduates and practitioners in providing appropriate vascular protocol for patients. They are not inflexible rules or requirements of practice and are not intended, nor should they be used, to establish a legal protocol standard of scanning. For these reasons and those set forth below, the American College of Radiology cautions against the use of these protocols in litigation in which the clinical decisions of a practitioner are called into question.


The practice of medicine involves nor only the science, but also the art of dealing with the prevention, diagnosis, alleviation, and treatment of disease. The variety and complexity of human conditions make it impossible to always reach the most appropriate diagnosis or to predict with certainty a particular response to treatment. Therefore, it should be recognized that adherence to these protocols will not assure an accurate diagnosis or a successful outcome. All that should be expected is that the graduate and/or practitioner will follow a reasonable course of action based on current knowledge, available resources.


The NCMA scope of practice of RVUS that we comprehend (Introduction, Indications, Specifications of the Examination, and Equipment Specifications) were developed under and followed the collaboratively by the American College of Radiology (ACR), the American Institute of Ultrasound in Medicine (AIUM), the Society for Pediatric Radiology (SPR), and the Society of Radiologists in Ultrasound (SRU).

 

Focused Specifiations for Individual Vascular Examination Protocol

For vascular examinations of the native or transplanted liver, Doppler evaluation should be used to document blood flow characteristics and blood flow direction. The structures that may be examined include the main and intrahepatic arteries, hepatic veins, main and intrahepatic portal veins, intrahepatic portion of the IVC, collateral venous pathways, and transjugular intrahepatic portosystemic shunt (TIPS) stents.

 

For vascular examination of the native or transplanted kidneys, Doppler can be used:
a. To assess renal arterial and venous patency
b. To evaluate suspected renal artery stenosis. For this application, angle-adjusted measurements of the peak systolic velocity should be made proximally, centrally, and distally in the extrarenal portion of the main renal arteries when possible. Peak systolic velocity of the adjacent aorta should also be documented for calculating the ratio of renal to aortic peak systolic velocity. Spectral Doppler evaluation of the intrarenal arteries may be of value as indirect evidence of proximal stenosis in the main renal artery.
c. For vascular examinations of the transplanted kidney(s), Doppler evaluation should be used to document vascular patency and blood flow characteristics. The structures that may be examined include the main renal artery and vein, arterial and venous anastomoses, the iliac artery and vein, and the intrarenal arteries.

 

Clinical competecny evaluation will be assessed on the following:
1. Anatomy and Physiology of vascular perfusion
2. DVT Hemodynamic
3. Physics of pressures, velocity, viscosity, flow, volume, Bernoulli principle, poiseulee's law, transmural pressure, energy
4. Anatomy of blood vessels and branches, CCA, vertebral arteries, subclavian arteries, lower and upper extremities, Ao
5. Hemodynamic and perfusion of blood vessels, "the portal vein"
6. Deep vs. superficial; blood vessels
7. Blood vessel pathologies
8. Vascular pathology vs. takayasu's
a. Athenomas
b. Stenosis
c. TIA
d. ACS
e. Hemorrhagic vs. ischemic stroke
f. RIND
g. VBI
h. Embolism
i. Aneurysm
j. Thrombosis
k. Carotid tumor
l. Cerebrovascular diseases
m. DUT
n. Paget-schroetter syndrome, SVC syndromes, maythurner syndrome
o. Systemic hypertension
p. Edema, raynaud's disease
q. Leg dermatosis
r. Blood vessels, ulcers

 

Anatomical sonographic appearance:
1. Abscess, effusion, claudication, cyst, hematoma, sensory receptor abnormalities, coarctation, entrapment compartment syndrome, subclavian stenosis
Vascular disease leading to surgical procedures:
1. Endarterectomy
2. Bypass graft
3. Bympathecomy
4. Thrombectomy
5. Embolectomy
6. Atherectomy
7. Pseudoanedrysm
8. Acute thrombosis
9. Chronic venous insufficiency
10. Hemostasis of blood vessels
11. Thrombolytic therapy
12. Endovascular therapy
13. Acute phlebitis
14. Venicose vein treatment
15. Infection control and universal precaution
16. Biosafety
17. Plethysmography and digital pressures
18. ABF
19. Doppler segmental pressures
20. Doppler waveform analysis
21. Transcutaneous oximetry

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