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12/09/04

Vascular Diagnostic Laboratory Gets Unconditional Approval

Mount Sinai's Marie-Josée and Henry R. Kravis Vascular Diagnostic Laboratory in the Zena and Michael A. Wiener Cardiovascular Institute has received accreditation from the Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL) in all four areas for which it applied. The four areas include extracranial cerebrovascular, peripheral venous, peripheral arterial, and visceral vascular. The Vascular Lab had previously been accredited in only the first three areas. Now it is one of the very few in the region to be accredited in these four.

"We received the accreditation in all four areas unconditionally," notes Jeffrey W. Olin, DO, Professor of Medicine (Cardiology), Director of Vascular Medicine, and Co-Director of the Vascular Diagnostic Laboratory, along with Victoria Teodorescu, MD, Associate Professor of Surgery. "The multidisciplinary accreditation process assures quality among labs. Most laboratories are given conditional approval if appropriate changes are made based on the ICAVL's recommendations. Since we met or surpassed all their requirements, there were no recommendations made to the Mount Sinai Vascular Laboratory. This is distinctly unusual."

The Vascular Lab, which in 2002 performed about 2,000 studies, currently performs close to 4,000 studies a year. During the accreditation process, every aspect of the lab's daily operations, as well as its impact on the quality of care provided to patients, was assessed and reviewed. While completing the application, labs are required to identify and correct potential problems, revise protocols, and validate quality assurance programs. "Just participating in the accreditation process demonstrates our attention to detail and to quality patient care and testing," says Dr. Olin.

The accreditation comes at a time when the Vascular Diagnostic Lab is already a leader in several areas of vascular medicine and vascular surgery. Dr. Olin has been a pioneer in developing noninvasive techniques to evaluate the blood supply to the kidneys and bowel. Renal artery duplex ultrasound can noninvasively diagnose narrowing of the arteries to the kidneys, which can cause high blood pressure and kidney failure. Under the direction of Dr. Olin (vascular medicine) and Dr. Teodorescu (vascular surgery), the Lab also performs such therapeutic procedures as ultrasound-guided thrombin injection, a technique that can seal off a hole in an artery that sometimes occurs after an arterial catheterization procedure. "Sometimes after catheterization, patients have a leak in the artery because it didn't seal properly," he says. "In the past, those patients would have to go to surgery to repair the hole. But this new minimally invasive technique enables us to treat the problem with no incision and often this is performed on an outpatient basis." To perform the procedure, the physician uses ultrasound to guide a needle into the chamber of the pseudo-aneurysm and injects thrombin into the chamber to seal the leak.

Beginning in 2006, physicians will receive credentialing to perform vascular interpretations. Dr. Olin is one of four physicians in the country who are working on the task force (of the American Registry of Diagnostic Medical Sonographers) responsible for developing the new physician test.