today i had a patient with very low flow .08 cm/sec in the mid rt vert.
fairly low resistant. more proximal there was reversed flow of the systolic
segment , very high resistive peak with an equaly sharp antigrade peak and
antigrade diastolic flow. i determined the systolic segment was reversed by
feeling pulse of temperal artery as was suggested here recently. reversed
systolic peak measure about .26 cm/sec. i imaged the rt subclavian and there
was some plague there and a 2.42 cm/sec high resistive waveform just distal to
the bifurcation. we took bilat brachial pressure and they were nearly equal. i
felt like this represented a partial steal syndrome, but i couldn't explain why
exactly. i wonder if anyone would like to offer an explanation as to why all
antigrade mid vert and both antegrade -retrograde more proximally. am i right
to assume this represents a partial steal. why wouldn't the waveform have the
same characteristic throughout the rt vert.
Robin Garza, RDMS,RVT