From Doppler to duplex: A personal early history of the vascular laboratory

In the mid-1970s, a group of clinicians and bioengineers at the University of Washington, under the direction of Dr D Eugene Strandness, Jr, built a prototype duplex scanner that combined B-mode imaging and pulsed Doppler flow detection in a single instrument. At that time, I was a general surgery resident with an interest in vascular disease, and arrangements were made for me to spend a year in the Strandness laboratory. The prototype duplex system was just being completed when I arrived in 1978, and I immediately became involved in a series of validation studies in which patients with carotid disease were scanned and spectral waveform parameters were correlated with independently read contrast arteriograms. This work resulted in the University of Washington duplex criteria for carotid artery disease, which have been widely adopted and modified. Subsequent advances in ultrasound technology expanded the applications of duplex scanning to the peripheral arteries and veins, as well as the abdominal vessels. In 1984, I joined Dr Strandness on the faculty in the Department of Surgery at the University of Washington where I have remained throughout my career. Over the years, I have had the opportunity to participate in many important developments, described in this article, that have helped to make the vascular laboratory the essential clinical resource that it is today.

The Need for Vascular Laboratory Accreditation Within the Veterans Administration

Vascular imaging accreditation is a significant platform for clinical diagnostic evaluation and correlation. There is a notifiable disconnect between the private imaging facilities and the federal imaging laboratories. Online medical forums have increased patient expectations which give a visual appearance of underutilization of qualified talent, within the federal imaging field. Encouraging federal leadership to pursue a patient quality centered approach that will increase patient advocacy and elevate the expectations of imaging personnel, for the Veteran patient.