D EXAM: TRANSTEMPORAL WINDOW / PCA – USES PW OR CW DOPPLER: CCA
= FLOW MOVING TOWARDS THE TRANSDUCER EXTRACRANIAL EXAM
= FLOW MOVING AWAY FROM THE TRANSDUCER TRANSCRANIAL EXAM
BOCCIPITAL WINDOW / PCA – PERIORBITAL EXAM ICA
= FLOW MOVES AWAY FROM TRANSDUCER
= FLOW MOVES TOWARDS THE TRANDUCER USES BLOOD PRESSURE CUFFS:
VERSED FLOW DIRRECTION FROM TRANSTEMPORAL VIEW)
PULSE VOLUME RECORDING (PVR) SYSTOLIC VELOCITY RATIO:
TO MEASURE VOLUME CHANGES
SENTERIC TO AO RATIO: 1.0 OR LESS = NORMAL
A/AO RATIO > 3.0 INDICATES SIGNIFICANT STENOSIS CCA: PSV 80 CM/S EDV 40 CM/S
L LEFT CLAUDICATION ICA: PSV 338 CM/S EDV 80 CM/S
NDARD WINDOWS FOR COMPLETE TCD EXAM:R ABI – 1.13
SUBOCCIPITAL L ABI – 1.37 SYSTOLIC VELOCITY RATIO
TRANSTEMPORAL TAKE TOE PRESSURES (TBI) = PSV ICA / PSV CCA
OPTHALMIC IF TBI IS ABNL, USE PVR WAVEFORMS 338 CM/S / 80 CM/S = 4.9
MANDIBULAR WINDOW IS A TO LOCATE OBSTRUCTION
PLEMENTAL VIEW FOR THE DISTAL ICA]
GONADAL VEIN DRAINS INTO THE LRV
HT GONADAL VEIN, HEPATIC VEINS, AND WHAT IS THE DIASTOLIC VELOCITY RATIO?
RENAL VEINS ALL DRAIN INTO THE IVC
ENIC VEIN IS PART OF THE PORTAL SYSTEM
ARC OF RIOLAN AND THE MARGINAL ARTERY OF DRUMMOND
ECT THE SMA AND THE IMA THRU THE MESENTRY AND OFFER DIASTOLIC VELOCITY RATIO:
ATERAL FOW IF MESENTRIC OBSTRUCTION OCCURS
CCA: PSV 80 CM/S EDV 40 CM/S
IN RISK FACTOR FOR A STROKE = SYSTEMIC HTN
ICA: PSV 338 CM/S EDV 80 CM/S
ACRANIAL ARTERIAL DUPLEX EXAM = CAROTID EXAM
PHASIC FLOW = 2 COMPONENTS DIASTOLIC VELOCITY RATIO
TEGRADE FLOW IN SYSTOLE = EDV ICA / EDV CCA PVR (TYPE OF ARTERIAL PLETHYSMOGRAPHY/PPG) +
TROGRADE FLOW IN DIASTOLE 82CM/S / 40 CM/S = 2.1
FOR TOS
SVC SYNDROME
RFORMING SERIAL EXAM ON AN
PROGRESSIVE OBSTRUCTION OF THE SVC CEREBRAL ANGIOGRAPHY = PREFERRED MODALITY
SITU VENOUS BYPASS GRAFT
VENOUS DILITATION OF THE UE’S AND NECK TO DIAGNOSE FMD IN THE CIRCLE OF WILLIS
ECREASE IN THE PSV OF 30 CM/S
ARM SWELLING
D/OR A DECREASE IN THE ABI OF 0.15 3 MAIN TYPES OF ARTERIOSCLEROSIS
BILATERAL DISTENSION OF IJV’S
DICATE SIGNIFIGANT GRAFT FAILURE. ATHEROSCLEROSIS – LARGE ARTERIES ARE HARDENED AND NARROWED
W/ CONTINUOUS FLOW PATTERN (IJV’S)
IAMETER MEASUREMENT FOR AO: LOSS OF RESPIRATORY PHASICITY (IJV’S) ARTERIOSCLEROSIS – THE CALCIFICATION OF SMALL ARTERIES
P IN SAGITAL, OUTER WALL TO OUTER WALL AND LOSS OF CARDIAC PULSITILITY (IJV’S) MOENCKEBERG MEDIAL CALCIFIC SCLEROSIS – STIFFNESS OR HARDENING
OF SMALL-MEDIUM ARTERIES
ROTID DISSECTION IS MORE COMMON IN THE
TRACRANIAL ICA THEN THE INTRACRANIAL ICA. CLUTTER ARTIFACT (COLOR BLEED) = COLOR SCALE TOO LOW
MEDIAL CALCIFICATION
T COMMON CAUSE FOR VENOUS ULCER FORMATION AKA MEDIAL ARTERY CALCIFICATION
DISTAL MEDIAL CALF = ATTRIBUTED TO THE PASV (MAC)
OR POSTERIOR ARCH VEIN AND THE PTV PERFORATORS AKA MOENCKEBERG’S
MAL WAVEFORM OF THE FEMORAL A. WITH CW DOPPLER: ARTERIOSCLEROSIS
ASIC, RAPID UPSTROKE, SHARP PEAK, RAPID DOWNSLOPE, THE 3-CUFF SEGMENTAL PRESSURE EXAM
IS THE MOST ACCURATE METHOD OF THIGH AKA MOENCKEBERG MEDIAL CALCIFIC
L PEAK BELOW BASELINE REPRESENTING DIASTOLIC FLOW
PRESSURE ASSESSMENT SCLEROSIS
RSAL FOLLOWED BY A SMALL PEAK ABOVE BASELINE
Systemic vascular disorder
ANSPLANT EVAL W/INTERPOSITION ANASTOMOSIS: Increase in arterial stiffness
R PARTIAL TRANSPLANT? TARDUS PARVUS WAVEFORM Diastolic heart failure
BACK OR INTERPOSITION ANASTOMOSIS? A RESULT OF SIGNIFIGANT PROXIMAL Impaired perfusion of high blood flow organs
MOST COMMON LOCATION OF VALVULAR / VENOUS INSUFFICIENCY:
ALL ANASTOMOSIS SITES ARTERIAL STENOSIS. WAVEFORM IS brain, kidney and liver
GSV AND CFV JUNCTION AKA SFJ SAPHENOUS/FEMORAL JUNCTION
CK: HEPATIC CONFLUENCE OF TRANSPLANT LIVER ATTACHED TO NATIVE IVC / SINGLE SITE
LOW RESISTANCE, LOW VELOCITY Chronic limb threatening ischemia (CLTI)
SITION: DONOR IVC SEGMENT REPLACES SEGMENT OF NATIVE IVC / 2 ANASTOMOSIS SITES
WITH A LATE SYSTOLIC PEAKCONJUNCTION OF THE IJV AND THE SUBCL. V = THE INNOMINATE VEIN
= FLOW MOVING TOWARDS THE TRANSDUCER EXTRACRANIAL EXAM
= FLOW MOVING AWAY FROM THE TRANSDUCER TRANSCRANIAL EXAM
BOCCIPITAL WINDOW / PCA – PERIORBITAL EXAM ICA
= FLOW MOVES AWAY FROM TRANSDUCER
= FLOW MOVES TOWARDS THE TRANDUCER USES BLOOD PRESSURE CUFFS:
VERSED FLOW DIRRECTION FROM TRANSTEMPORAL VIEW)
PULSE VOLUME RECORDING (PVR) SYSTOLIC VELOCITY RATIO:
TO MEASURE VOLUME CHANGES
SENTERIC TO AO RATIO: 1.0 OR LESS = NORMAL
A/AO RATIO > 3.0 INDICATES SIGNIFICANT STENOSIS CCA: PSV 80 CM/S EDV 40 CM/S
L LEFT CLAUDICATION ICA: PSV 338 CM/S EDV 80 CM/S
NDARD WINDOWS FOR COMPLETE TCD EXAM:R ABI – 1.13
SUBOCCIPITAL L ABI – 1.37 SYSTOLIC VELOCITY RATIO
TRANSTEMPORAL TAKE TOE PRESSURES (TBI) = PSV ICA / PSV CCA
OPTHALMIC IF TBI IS ABNL, USE PVR WAVEFORMS 338 CM/S / 80 CM/S = 4.9
MANDIBULAR WINDOW IS A TO LOCATE OBSTRUCTION
PLEMENTAL VIEW FOR THE DISTAL ICA]
GONADAL VEIN DRAINS INTO THE LRV
HT GONADAL VEIN, HEPATIC VEINS, AND WHAT IS THE DIASTOLIC VELOCITY RATIO?
RENAL VEINS ALL DRAIN INTO THE IVC
ENIC VEIN IS PART OF THE PORTAL SYSTEM
ARC OF RIOLAN AND THE MARGINAL ARTERY OF DRUMMOND
ECT THE SMA AND THE IMA THRU THE MESENTRY AND OFFER DIASTOLIC VELOCITY RATIO:
ATERAL FOW IF MESENTRIC OBSTRUCTION OCCURS
CCA: PSV 80 CM/S EDV 40 CM/S
IN RISK FACTOR FOR A STROKE = SYSTEMIC HTN
ICA: PSV 338 CM/S EDV 80 CM/S
ACRANIAL ARTERIAL DUPLEX EXAM = CAROTID EXAM
PHASIC FLOW = 2 COMPONENTS DIASTOLIC VELOCITY RATIO
TEGRADE FLOW IN SYSTOLE = EDV ICA / EDV CCA PVR (TYPE OF ARTERIAL PLETHYSMOGRAPHY/PPG) +
TROGRADE FLOW IN DIASTOLE 82CM/S / 40 CM/S = 2.1
FOR TOS
SVC SYNDROME
RFORMING SERIAL EXAM ON AN
PROGRESSIVE OBSTRUCTION OF THE SVC CEREBRAL ANGIOGRAPHY = PREFERRED MODALITY
SITU VENOUS BYPASS GRAFT
VENOUS DILITATION OF THE UE’S AND NECK TO DIAGNOSE FMD IN THE CIRCLE OF WILLIS
ECREASE IN THE PSV OF 30 CM/S
ARM SWELLING
D/OR A DECREASE IN THE ABI OF 0.15 3 MAIN TYPES OF ARTERIOSCLEROSIS
BILATERAL DISTENSION OF IJV’S
DICATE SIGNIFIGANT GRAFT FAILURE. ATHEROSCLEROSIS – LARGE ARTERIES ARE HARDENED AND NARROWED
W/ CONTINUOUS FLOW PATTERN (IJV’S)
IAMETER MEASUREMENT FOR AO: LOSS OF RESPIRATORY PHASICITY (IJV’S) ARTERIOSCLEROSIS – THE CALCIFICATION OF SMALL ARTERIES
P IN SAGITAL, OUTER WALL TO OUTER WALL AND LOSS OF CARDIAC PULSITILITY (IJV’S) MOENCKEBERG MEDIAL CALCIFIC SCLEROSIS – STIFFNESS OR HARDENING
OF SMALL-MEDIUM ARTERIES
ROTID DISSECTION IS MORE COMMON IN THE
TRACRANIAL ICA THEN THE INTRACRANIAL ICA. CLUTTER ARTIFACT (COLOR BLEED) = COLOR SCALE TOO LOW
MEDIAL CALCIFICATION
T COMMON CAUSE FOR VENOUS ULCER FORMATION AKA MEDIAL ARTERY CALCIFICATION
DISTAL MEDIAL CALF = ATTRIBUTED TO THE PASV (MAC)
OR POSTERIOR ARCH VEIN AND THE PTV PERFORATORS AKA MOENCKEBERG’S
MAL WAVEFORM OF THE FEMORAL A. WITH CW DOPPLER: ARTERIOSCLEROSIS
ASIC, RAPID UPSTROKE, SHARP PEAK, RAPID DOWNSLOPE, THE 3-CUFF SEGMENTAL PRESSURE EXAM
IS THE MOST ACCURATE METHOD OF THIGH AKA MOENCKEBERG MEDIAL CALCIFIC
L PEAK BELOW BASELINE REPRESENTING DIASTOLIC FLOW
PRESSURE ASSESSMENT SCLEROSIS
RSAL FOLLOWED BY A SMALL PEAK ABOVE BASELINE
Systemic vascular disorder
ANSPLANT EVAL W/INTERPOSITION ANASTOMOSIS: Increase in arterial stiffness
R PARTIAL TRANSPLANT? TARDUS PARVUS WAVEFORM Diastolic heart failure
BACK OR INTERPOSITION ANASTOMOSIS? A RESULT OF SIGNIFIGANT PROXIMAL Impaired perfusion of high blood flow organs
MOST COMMON LOCATION OF VALVULAR / VENOUS INSUFFICIENCY:
ALL ANASTOMOSIS SITES ARTERIAL STENOSIS. WAVEFORM IS brain, kidney and liver
GSV AND CFV JUNCTION AKA SFJ SAPHENOUS/FEMORAL JUNCTION
CK: HEPATIC CONFLUENCE OF TRANSPLANT LIVER ATTACHED TO NATIVE IVC / SINGLE SITE
LOW RESISTANCE, LOW VELOCITY Chronic limb threatening ischemia (CLTI)
SITION: DONOR IVC SEGMENT REPLACES SEGMENT OF NATIVE IVC / 2 ANASTOMOSIS SITES
WITH A LATE SYSTOLIC PEAKCONJUNCTION OF THE IJV AND THE SUBCL. V = THE INNOMINATE VEIN
