you have the same type issues with peripheral intervention, and sheaths. When you pull the sheath, you typically get a arterial spasm which will also produce falsely elevated velocities.. Thus, you look for an immediate post op pseudo and the EIA or CFA is elevated.
Jason
> Date: Fri, 2 Jul 2010 09:20:34 -0700
> From: [log in to unmask]
> Subject: Re: Intra operative carotid duplex velocities after endarterectomy
> To: [log in to unmask]
>
> 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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