Wow! you Vandenbergs stick together!  Norma - I have had a similar
experience to Carol looking at Klipplel-Trenaunay patients - nothing shows.
Unless, of course, they have Klipplel-Trenaunay"Weber" (1 or 2 "b's"?)-
where veins are absent. That is usually why we see them - to document the
presence or absence of normal venous anatomy.  bj

Bonnie L. Johnson RDMS, RVT, FSVT
Stanford Medical Center
Director, Vascular Laboratory Services
Division of Vascular Surgery
Stanford, CA


-----Original Message-----
From: UVM Flownet [mailto:[log in to unmask]]On Behalf Of Bill
Vandenberg
Sent: Tuesday, April 18, 2000 5:19 PM
To: [log in to unmask]
Subject: Re: A-V malformations


Norma, sounds like Klippel-Trenaunay Syndrome. The book states the a-v
fistulas are microscopic type communicators, may be hard to see. Hope this
helps. Carol Vandenberg, RN, RVT

Norma VandenBerghe wrote:

> I have a question about using duplex US to identify and localize
> congenital arterio-venous malformations.  I have had a few cases through
> the years, and have not really had much luck with tracking the little
> devils down.  I have been able to predict a couple of intracranial cases
> based on the differences between the flow signals in the two carotid
> arteries.  But in the extremities, as on the child I saw today with
> hugely distended veins and even small venous ulcerations on his left
> leg, they have remained elusive.  I looked at the entire arterial system
> for low resistance or turbulence;  I looked at the entire venous system
> for arterialized flow, pulsation, etc.  And found nothing.  No
> difference compared to the same site on the unaffected right leg.  I
> looked at iliacs and all the way down the leg.  I tried to just look for
> abnormal color flow.  I looked with velocity scale set high.  Set low.
> Gain up, down etc. Nothing.
>
> Have others had more success than I have?  I feel like I must be
> overlooking something.
> Thanks!   Norma V.