DId you perform hyperemia on the patient? Place a blood pressure cuff on the
affected arm, pump it up to 200mmHg and hold it there for about 2 minutes.
Image your vertebral with the blood pressure cuff at 200mmHg. and record the
flow. Then release the cuff and image the vertebral again and see if your
flow changes direction. If it does, it definitely is stealing.
> -----Original Message-----
> From: Robin Garza [SMTP:[log in to unmask]]
> Sent: Tuesday, August 29, 2000 9:13 PM
> To: [log in to unmask]
> Subject: retro vert
> 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
> segment , very high resistive peak with an equaly sharp antigrade peak
> antigrade diastolic flow. i determined the systolic segment was reversed
> feeling pulse of temperal artery as was suggested here recently.
> systolic peak measure about .26 cm/sec. i imaged the rt subclavian and
> 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
> antigrade mid vert and both antegrade -retrograde more proximally. am i
> to assume this represents a partial steal. why wouldn't the waveform have
> same characteristic throughout the rt vert.
> Robin Garza, RDMS,RVT