Today was the first day of the conference and so many exciting and amazing events took place. To begin with, a keynote address took place. Dr. Eugene Zierler MD RPVI, took us on “An Interprofessional Odyssey” where he talked about the beginnings of vascular ultrasound (image below). He talked a lot about the vascular technology correlating well with vascular surgery. He also mentioned ARDMS and the history behind the organization. He received an award with a standing ovation today at the conference for his research on the clinical applications of noninvasive diagnostic techniques for vascular disease. Just within that first hour, I learned a lot from Dr. Zierler! Many techs who perform carotid exams on a regular basis know that if the ICA PSVs are less than 125 cm/s, it is usually a normal vessel. However, no one could really say where that 125 cm/s came from, but Dr. Zierler had the answer! He mentioned that the Doppler frequency shift for those exams is usually 4 KHz, which is roughly 125 when converted to cm/s. It makes so much more sense now!! He also mentioned that NASCET helped to identify a 70% stenosis, which was later added to the University of Washington criteria!
Next, the first cerebral session of the day started. We had about 5 speakers who all had so much to say about the cerebral system! First, we learned a lot about the formation of plaque and atherosclerosis within our arteries. Next, we learned about contrast-enhanced ultrasound (image above) from one of our very own cardiologists at Rush, Dr. Steven Feinstein MD. I actually really liked this idea because it helped to better image the carotid IMT, the better identify the carotid bifurcation, and better understand the plaque present in the arteries. It seemed very efficient and useful overall. Finally, we learned a ton about non-atherosclerotic disease and the carotid IMT. Then, we had a live scanning session where a technologist scanned a patient to show us how and where to measure the IMT in the carotid arteries (image below). We all learned about the edge detector, which was fairly new technology that can aid in identifying the IMT better. To finish the first session, there was a questions and answers portion. Here we met many of the other techs and physicians in the audience who had some really interesting questions for the presenters. People visited the SVU Annual Conference from all over the nation, and the world such as Brazil and Canada! Then, we dispersed for refreshments, where I got to meet some of my fellow students and professors from Rush. It was really good to see some familiar faces! I met my professors Donna Blackburn and Laurie Lozanski!
After a few refreshments, we returned to the hall to talk some more about the cerebral system. This time, Dr. Zierler took to the podium once more to tell us about whether 60-degrees during an exam was really the gold standard or not. It was a great review of physics and the Doppler Equation. Overall, he concluded that 30-degrees to 60-degrees is really optimal but 60-degrees has stuck due to it’s widespread use. Next, Dr. Perler presented to us the pros and cons of stenting the carotid artery as opposed to performing a carotid endarterectomy. He concluded that performing the endarterectomy is still the gold standard but “carotid stents are here to stay!” He said to focus more on evidence-based medicine as opposed to focusing on your own or the patient’s emotions. Lastly, we had Dr. Sorond MD PhD explain a ton to us about the TCD exam, ending with a cool simulation! The simulation was probably my favorite part of today because I’ve never seen anything like it (image above). With the simulation, Dr. Sorond displayed various exams under different conditions. An example is a moderate to severe carotid stenosis was simulated to display emboli detection. We learned that it was fairly easy to detect emboli through the TCD, but the exam was time consuming. We also learned that reverberating flow present in the circle of Willis was indicative of brain death. Finally following another Q&A session, we dispersed for lunch!