Vascular Ultrasound 2023 with complete solution

If a high grade stenosis or occlusion is seen in a renal artery how will the contralateral waveform appear? It will still be a low resistance waveform but it will appear weakened or dampened. How can increased resistance be determined? Checking Parenchymal Resistance Ratio and the Resistive Index Where should waveforms be obtained when checking renal resistance? Waveform and peak velocity measurements in the upper and lower pole PR? What is it? Equation? Normal value? Parenchymal Resistance Ratio End Diastolic Velocity Divided by the Peak Systolic Velocity Normal is 0.2 RI? What is it? Equation? Normal Value? Resistive Index Peak Systolic Velocity minus the End Diastolic Velocity Divided by the Peak Systolic Velocity Normal 0.75 What Peak Systolic Velocity Measurement Indicates diameter stenosis of the SMA greater than or equal to 70%? Fasting PSV equal to or greater than 275 cm/sec indicates a 70-99 % diameter stenosis What PSV indicates a diameter reduction of the Celiac Artery equal to or greater than 70 %? PSV equal to or greater than 200 cm/sec indicates a 70-99% diameter reduction What can cause extrinsic compression of the celiac artery? Median Arcuate Ligament during exhalation When Inhalation occurs the diaphragm moves back down and compression is released. What are the branches of the celiac artery? Type of resistance seen in the vessels? Does eating affect the waveforms? Splenic and Hepatic Arteries All low resistance Not affected by eating Most common post-op complications after a liver transplant? (4) 1. Hepatic artery occlusion causing a hepatic infarct 2. PV Thrombosis 3. Pseudoaneurysm Formation 4. IVC thrombosis If a low resistance waveform is seen in a peripheral artery what could this indicate? (3) 1. The limb is being exercised. 2. There is an arterial obstruction in the limb 3. There is an arteriovenous fistula and the waveform is being taken proximal to the fistula. What is the peripheral vascular system? The veins and arteries that supply the extremities. Post operative extremity weakness in the calf muscle with foot drop, parasthesia and pain with passive motion of the muscle would indicate what diagnosis? Treatment? Compartment Syndrome Treatment: Fasciotomy where the fascia is surgically split to relieve pressure Increased renal artery flow resistance following a transplant indicates? (4) 1. Acute rejection 2. Renal Vein Thrombosis 3. Infection 4. Tubular Necrosis What is an AVF? Causes? Arteriovenous Fistula Abnormal connection between an artery and a vein Causes- Congenital and Traumatic Describe the flow patterns of an AVF. Artery will become less pulsatile with lower resistance( increased diastolic component) At the point of connection will see higher velocities and turbulence Vein becomes pulsatile