Optimal resources for the examination and endovascular treatment of the peripheral and visceral vascular systems. AHA Intercouncil Report on Peripheral and Visceral Angiographic and Interventional Laboratories.

In 1969 the Intersociety Commission for Heart Disease Resources was established through a contract with the American Heart Association under Public Law 89-239. Its responsibility was to produce guidelines defining optimal medical resources and care for the prevention and treatment of cardiovascular disease, including guidelines for radiologic facilities (1). This resource guideline was revised in 1976 (2) and again in 1983 (3). The Intersociety Commission was disbanded shortly thereafter, but a joint ad hoc task force of the American Heart Association and the American College of Cardiology continued this work with “Guidelines for Cardiac Catheterization and Cardiac Catheterization Laboratories” (4), published in 1991. The task force concluded that “. . . while noncardiac diagnostic and therapeutic procedures are growing in number . . . guidelines for these services are beyond the scope of this document.” These documents have charted the evolution of cardiac catheterization from a procedure performed in a few highly specialized laboratories for cardiovascular research to one performed in a number of interventional cardiac laboratories. The documents also have provided useful optimal resource guidelines. In the 1983 report similar standards for angiographic facilities were implied but never specifically stated, with the emphasis always on the heart. Nevertheless, the report mentioned angiographic facilities and considerable involvement by radiologists. Just as cardiac catheterization has evolved, so too have peripheral and visceral angiography. Diagnostic angiography proliferated in the 1960s and the 1970s, and interventional radiology emerged in the 1980s. Nevertheless, optimal resource standards have never been promulgated except in an abbreviated form (5). In 1989 the Council Affairs Committee of the AHA approved the formation of a committee on peripheral vascular disease under the auspices of the Council on Cardiovascular Radiology. In 1992 an ad hoc task force was created, with members from the Councils on Cardiovascular Radiology, Cardio-Thoracic and Vascular Surgery, Clinical Cardiology, and Kidney in Cardiovascular Disease, to develop guidelines for peripheral and visceral angiographic and interventional laboratories. Task force members are Eric C. Martin, MD, chair; William J. Casarella, MD (Council on Cardiovascular Radiology); Barry T. Katzen, MD (Council on Cardiovascular Radiology); Gerald M. Dorros, MD (Council on Clinical Cardiology); Gary S. Roubin, MD (Council on Clinical Cardiology); James A. DeWeese, MD (Council on Cardio-Thoracic and Vascular Surgery); and John H. Laragh, MD (Council on Kidney in Cardiovascular Disease). The task force is grateful for the contributions of the following consultants: John F. Cardella, MD; Joel E. Gray, PhD; Victoria M. Marx, MD; Edward L. Nickoloff, ScD; Michael J. Pentecost, MD; and David C. Levin, MD.