Pediatric Vascular Laboratory

Like adults, children are at risk for developing atherosclerosis and arterial stiffness, as early as the newborn period. Several conditions can lead to unhealthy arteries in children, such as hypercholesterolemia, hypertension, organ transplantation, coarctation of the aorta, Kawasaki disease, rheumatologic disease, HIV or Fontan circulation.

Seda Tierney, MD, director of the Pediatric Vascular Research Laboratory, stresses the good news that vascular dysfunction is reversible if identified early. “We can improve vascular health in our young patients with simple interventions like exercise, rather than taking action only after they develop acute problems later in life,” she says.

The Pediatric Vascular Laboratory offers simple noninvasive tests to assess vascular health in children

• Endothelial pulse amplitude testing measures endothelial function in peripheral arteries, representing the best noninvasive method to detect early signs of abnormal arterial health. For this test, we place small thimble-like probes on the fingers to measure blood flow. After temporary flow occlusion in the arm with a blood pressure cuff, blood flow naturally increases in healthy arteries. If an artery does not dilate enough, there is endothelial dysfunction.
• Arterial applanation tonometry is a noninvasive test that uses a pressure sensor the size of a pencil to record pulse pressure at peripheral arterial sites. Tonometry is used to measure arterial stiffness. The stiffer an artery is, the faster blood travels (its pulse wave velocity) and the more it gets augmented by the faster return of the waves (its augmentation index).
• Carotid artery ultrasound allows us to examine structural properties of an artery. Intima-media thickness (IMT) is the width of the two inner layers of the arterial wall, which thicken when an artery is unhealthy.

For referrals

To refer your child or patient to the Pediatric Vascular Laboratory for assessment, please email Dr. Seda Tierney at tierneys@stanford.edu and lead sonographer Katie Jo Stauffer at KStauffer@stanfordchildrens.org.