Abstract
The availability of a specific, detailed, and well-validated examination protocol is a cornerstone of vascular laboratory practice. Of course, every routine examination was new once, and rare or unusual clinical problems can lead to requests for examinations that do not have established protocols. This report by Meagan J Shaw, BS, RVT, from UC Davis Health describes such a case in which a prenatal fetal ultrasound identified a vascular abnormality which was later confirmed to be internal jugular vein phlebectasia by postnatal imaging in the vascular laboratory.
Although fetal ultrasound is an important component of Ob/Gyn sonography, it is outside the scope of vascular laboratory practice, and there are relatively few specific protocols for vascular testing on infants. However, Ms. Shaw was able to perform a successful diagnostic study by relying on general anatomic and ultrasound principles. This case illustrates the concept that when there is no formal protocol for an examination, a resourceful vascular sonographer can create one. This is how most vascular tests that are now routine started, recent examples being the screening examination for giant cell arteritis and pedal acceleration time. So, a key learning point from this case is that lack of a protocol is not a barrier—it is an opportunity.