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doppler shift = 2 x velocity of blood x transducer frequency
Doppler Equation
x cos0 / propagation speed
V= speed of u/s tissue x doppler freq ÷ 2 x transducer freq
Equation to calculate velocity
x cosine angle
What type of transducer is used for lower extremity scan-
5-7 linear array transducer
ning?
What is the recommended patient position for lower ex- Supine with hip minimally rotated externally and knee
tremity scanning? slightly flexed
In what position can the popliteal space be accessed
Lateral decubitus
during lower extremity scanning?
Which arteries should be evaluated during lower extrem-
From distal external iliac artery to trifurcation arteries
ity scanning?
What measurements are taken to assess stenosis during Prestenotic PSV, Stenotic segment PSV, and Poststenotic
lower extremity scanning? PSV with greater than 50% diameter reduction
Velocity Ratio Equation Highest PSV ÷ Pre- Stenotic PSV
> 2:1 velocity ratio increase = >50% diameter reduction
> 4:1 velocity ratio increase = >75% diameter reduction
Lower extremity stenosis ( velocities)
> 400 cm/sec = > 75% diameter reduction
** also used in native Arteries in bypass grafts**
Distal Superficial Femoral Artery
Lower extremity stenosis commonly occur? Adductor/ Hunters Canal
Proximal Popliteal Artery
Synthetic (PTFE)
Types of grafts Reversed saphenous vein
In Situ vein
Reversed saphenous vein graft
, RVT ARDMS Comprehensive Resource To Help You Ace 2026-2027 Exams Includes Frequently
Tested Questions With ELABORATED 100% Correct COMPLETE SOLUTIONS Guaranteed Pass
First Attempt!! Current Update!!
Small end proximal , large end distal, valves stay open,
branches ligated
Once the vein is connected to the artery it becomes arte-
rialized
Retained valves are common site of stenosis/ obstruction
Cons to Reversed saphenous vein graft
of flow
The greater saphenous vein proximal end large and distal
In-situ Graft end small, venous valves broken up with a special instru-
ment and branches ligated
Con to In-situ Graft Branches not ligated can form Arteriovenous Fistulas
Image the bypass grafts in gray scale, color
Obtain Ankle and Brachial indices
Obtain PSV
Protocols for bypass grafts ° Proximal Native Inflow artery
° Proximal Anastomosis
° Distal Anastomosis
° Distal Native Outflow artery
Anastomotic Aneurysm
Con for synthetic graft
(Blood flow leaking through suture lines)
What transducer frequency should be used post proce-
12-15 MHZ
dure for bypass graft technique?
What is considered a normal findings in a post procedure PSV > 45 cm/sec
bypass graft? Low resistance flow in the Distal graft outflow artery
What are the abnormal findings post procedure for by-
pass graft technique?
, RVT ARDMS Comprehensive Resource To Help You Ace 2026-2027 Exams Includes Frequently
Tested Questions With ELABORATED 100% Correct COMPLETE SOLUTIONS Guaranteed Pass
First Attempt!! Current Update!!
PSV Decrease >30 cm/sec,
Change in waveform,
Decrease in ABI > 0.15
Repair of a bypass graft is needed if ? The PSV > 300 cm/sec and SVR > 4 ( Systolic velocity ratio)
Endoscopic vein harvesting: a small endoscope is used
with a tiny camera on the end , entered through a one inch
incision
Reduces wound complications
Bypass graft surgical therapy
Endoscopic VS Open Saphenous vein harvesting
Open Saphenous vein harvesting: surgically removed
through long incision
Complications include wounds, pain, nerve irritation or
prolonged recovery
What transducer is used for Duplex scanning abdominal
3-5 MHZ curvilinear
vessels
Right flank - Left lateral decubitus
Left flank - Right Lateral decubitus
Patient position for access to the right flank and left flank
< 50% minimal flow disturbance
Aortoiliac Arteries Stenosis > 50% = > 2:1 velocity increase
> 75% = 4:1 velocity increase
Aorta measuring > 3cm
Other vessel 1 1/2 times adj artery
Aortoiliac Aneurysm
renal artery duplex evaluation indication?