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July 2010

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Subject:
From:
"Rosendahl, Thomas, RN BS RVT" <[log in to unmask]>
Reply To:
UVM Flownet <[log in to unmask]>
Date:
Fri, 2 Jul 2010 09:20:34 -0700
Content-Type:
text/plain
Parts/Attachments:
text/plain (75 lines)
I don't believe the concept of "reactive hyperemia" was mentioned in
this thread. We were doing a lot of these intraoperative studies from
1990- 1994 and found many elevated flow velocities in the
endarterectomized ICAs attributed to this.
    Tom Rosendahl, RN BS RVT
     Cedars-Sinai Medical Center
        Los Angeles, CA

-----Original Message-----
From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Norman
Paley
Sent: Thursday, July 01, 2010 6:47 PM
To: [log in to unmask]
Subject: Re: Intra operative carotid duplex velocities after
endarterectomy

The surgeon in question does usually create a patch.  They generally
seem to be of the relatively "tight" variety, however.  Nevertheless, it
could still affect the velocity profile.

Thank you all for the interesting replies.



Norman Paley, BS, RVT
Technical Director Vascular Laboratory
Richmond University Medical Center
Staten Island, New York


Jun 29, 2010 09:50:14 PM, [log in to unmask] wrote:

===========================================

Within the past year we have begun doing intra operative duplex
ultrasound  
evaluation of the carotid artery immediately after completion of carotid

endarterectomy.  Our experience has been that, although, the lumen of
the  
vessel looks fine after the procedure, the peak systolic velocities have

tended to be relatively low.  My thought on this is that the artery, now

stripped of its fascia and surrounding tissues, is able to dilate more  
easily with each pulse of blood going through it resulting in a lower
peak  
velocity at a given volume compared with its unoperated state.  Does  
anybody have any experience with intra operative ultrasound during
carotid  
endarterectomy and, if so, do you find similar, or any differences in
the  
velocities?  Thank you in advance for any replies.



Norman Paley, BS, RVT
Technical Director Vascular Laboratory
Richmond University Medical Center
Staten Island, New York

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