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Ultrasound in Clinical DiagnosisFrom pioneering developments in Lund to global application in medicine$
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Bo Eklöf, Kjell Lindström, and Stig Persson

Print publication date: 2011

Print ISBN-13: 9780199602070

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780199602070.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 06 December 2021

The development of ultrasound in vascular disease in Sweden

The development of ultrasound in vascular disease in Sweden

(p.95) Chapter 9 The development of ultrasound in vascular disease in Sweden
Ultrasound in Clinical Diagnosis

Tomas Jogestrand

Olav Thulesius

Oxford University Press

The famous British scientist Sir Cyril A. Clarke in 1975 wrote the introduction for a new book, Arteries and Veins , with the following words: . . . In spite of all advances, mortality remains a steady 100 per cent and it is disorders of the arteries and veins which claim the majority of us. we sclerose, we clot, arrhythmias hit us, or our tubing wears out. By way of consolation, however, more of us now go the way of all flesh properly diagnosed and there are many ways of cheating the ancient enemy. . . . Clark at the time did not realize what advances were ahead of him, and the book he introduced with these dark lines included a chapter by R.G. Gosling and D.H. King which described a new promising technique of ultrasound angiography. Cyril Clark himself died at the age of 93! Blood flow measurements during resting conditions fail to detect any reduction of volume flow in patients with occlusive vascular disease, therefore for quantitative evaluation of the functional capacity of the peripheral circulation various functional tests implying increased circulatory demands needed to be introduced. The most useful clinical information could be obtained from peak-flow values after a period of obstruction and exercise followed by volume plethysmographic measurements of blood flow. Olav Thulesius introduced a foot ergometer in 1963 which allowed detection of maximal blood flow after graded muscular exercise. Its use was complicated and time-consuming when applied in conjunction with blood flow measurements with a water-filled volume plethysmograph. Therefore a faster and easier method for determination of peripheral blood flow was desirable. In 1967, the ultrasound scanning method for the detection of arterial blood flow signals in the diagnosis of fetal life during pregnancy was introduced in Sweden. This same principle became the method for detecting blood flow in peripheral blood vessels. The method used was a hand-held instrument which included two piezoelectric elements, one to transmit ultrasound signals and the other to receive the returning echoes back-scattered from the blood vessels. The instrument used for the detection of peripheral blood flow was the same as that for the detection of the fetal blood flow in pregnancy.

Keywords:   Doppler effect, Sigma-motor pump, carotid angiography, diabetes, foot ergometer, infrainguinal bypass surveillance, occlusive arterial disease, peripheral blood flow, stroke

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