LISTSERV mailing list manager LISTSERV 16.5

Help for UVMFLOWNET Archives


UVMFLOWNET Archives

UVMFLOWNET Archives


UVMFLOWNET@LIST.UVM.EDU


View:

Message:

[

First

|

Previous

|

Next

|

Last

]

By Topic:

[

First

|

Previous

|

Next

|

Last

]

By Author:

[

First

|

Previous

|

Next

|

Last

]

Font:

Proportional Font

LISTSERV Archives

LISTSERV Archives

UVMFLOWNET Home

UVMFLOWNET Home

UVMFLOWNET  September 2007

UVMFLOWNET September 2007

Subject:

Re: DIAMETER REDUCTION MEASUREMENTS

From:

SUBSCRIBE UVMFLOWNET robert rosner <[log in to unmask]>

Reply-To:

UVM Flownet <[log in to unmask]>

Date:

Fri, 7 Sep 2007 23:16:19 -0400

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (81 lines)

On Fri, 7 Sep 2007 13:10:35 -0400, Macclellan <NJMacclellan@COLLINS-
CC.K12.OH.US> wrote:

>I HAVE JUST STARTED FILLING IN FOR A VASCULAR SURGEON PERFORMING 
VASCULAR SONOGRAPHY.  HE IS REQUESTING DIAMETER REDUCTION 
CALCULATIONS THROUGHOUT THE EXTRACEREBRAL VASCULAR EXAMINATION.  
I HAVE AN OPINION, HOWEVER, I WOULD LIKE TO KNOW IF ANYONE IS 
PERFORMING THIS ROUTINELY, ARE YOU PERFOMING THIS CALCULATION IN 
LONG OR TRANS.  THANKS FOR ALL RESPONSES.
>NANCYMAC
>Nancy MacClellan BA, RDMS, RVT
>Program Director, DMS
>Collins Career Center
>740-867-6641, extension 526
>[log in to unmask]
>
>To unsubscribe or search other topics on UVM Flownet link to:
>http://list.uvm.edu/archives/uvmflownet.html


Nancy, 

Forget the longitudinal part! That is way too much to think that any 
sonographer with any spacial relationship skills would EVER depend on, let 
alone a fairly intelligent surgical group! Yikes!

What possibly could the physician's rationale be for attempting to determine %
stenosis calculations via diameter reduction measurements when this is so 
blasted outdated? (Dr. Strandness, RIP and hang in there friend. No need to 
roll over) :O)   

So many vessels are often calcified in this target population age, and even 
with rotational, window-searching scanning approach, valsalva to distend the 
jugular window techniques..... calcification's often "beat" ultrasound regarding 
penetrability. Give me a soft plaque anytime, and I'll build you a case. MRA's 
often end up kissing my butt come post-angio and post-surg because they 
can and do mislead Radiologists. We can do better with ultrasound! Remember 
folks, we are examining a fairly simple tube with fluid dynamics. Velocities RULE 
for % stenosis in the mod to critical range.

In 3 decades of scanning, I have noted many times velocities are WNL, but 
there is a nasty, irregular or smooth annular plaque that can appear to 
stenose an ICA bulb by 60% on transverse views. Sure, the complex 
hemodynamics in the bulb get modified and streamlined, but still less than 
twice a distal CCA velocity measurement, right? 

THINKING::::Gee, do ya think the rest of the arterial system has the same 
atherosclerotic burden? Is that more important than silly calcifications with 
minimal diameter reductions? NAH!!::::

Longitudinal views for % stenosis? Lawdy, tell me these guys are NOT serious!!

Other than plaque pathology and Intima-media thickness, VELOCITIES and 
ratios, judiciouisly appled, are the only way to go to accurately gauge a 
stenosis, using color doppler as your guide with the correct PRF threshold 
initially to broadly "check out the whole tube", and then to be used to find max 
jet velocities by increasing the PRF till the location of max velocity is revealed.

If one has not spent following up NIC exams and correlating them with 
subsequent angiograms, MRA's, digi-subtr, or whatever, (are you out there?) 
then Mr./Mrs. Sonographer will never learn from his/her mistakes or judgement 
errors. Nor do many WANT to learn. They know it all, you know. :O/

And did I mention it's a marvelous idea to keep your insonation angle at 60% 
ALWAYS, and heel/toe and use colorbox/insonation angle changes to your 
advantage. Consistancy, scanning acuity and agressiveness RULES and will 
make you a prized sniper for your docs, and ultimately the patients you help 
them to initially diagnose.

"I WOULD LIKE TO KNOW IF ANYONE IS PERFORMING THIS ROUTINELY, ARE 
YOU PERFOMING THIS CALCULATION IN LONG OR TRANS.  THANKS FOR ALL 
RESPONSES"

No, and neither. I wish you the best of luck and let us know what in god's 
name these docs want with the technology we have at hand here, ok Nancy?

RR

To unsubscribe or search other topics on UVM Flownet link to:
http://list.uvm.edu/archives/uvmflownet.html

Top of Message | Previous Page | Permalink

Advanced Options


Options

Log In

Log In

Get Password

Get Password


Search Archives

Search Archives


Subscribe or Unsubscribe

Subscribe or Unsubscribe


Archives

October 2020
September 2020
August 2020
July 2020
June 2020
May 2020
April 2020
March 2020
February 2020
January 2020
December 2019
November 2019
October 2019
September 2019
August 2019
July 2019
June 2019
May 2019
April 2019
March 2019
February 2019
January 2019
December 2018
November 2018
October 2018
September 2018
August 2018
July 2018
June 2018
May 2018
April 2018
March 2018
February 2018
January 2018
December 2017
November 2017
October 2017
September 2017
August 2017
July 2017
June 2017
May 2017
April 2017
March 2017
February 2017
January 2017
December 2016
November 2016
October 2016
September 2016
August 2016
July 2016
June 2016
May 2016
April 2016
March 2016
February 2016
January 2016
December 2015
November 2015
October 2015
September 2015
August 2015
July 2015
June 2015
May 2015
April 2015
March 2015
February 2015
January 2015
December 2014
November 2014
October 2014
September 2014
August 2014
July 2014
June 2014
May 2014
April 2014
March 2014
February 2014
January 2014
December 2013
November 2013
October 2013
September 2013
August 2013
July 2013
June 2013
May 2013
April 2013
March 2013
February 2013
January 2013
December 2012
November 2012
October 2012
September 2012
August 2012
July 2012
June 2012
May 2012
April 2012
March 2012
February 2012
January 2012
December 2011
November 2011
October 2011
September 2011
August 2011
July 2011
June 2011
May 2011
April 2011
March 2011
February 2011
January 2011
December 2010
November 2010
October 2010
September 2010
August 2010
July 2010
June 2010
May 2010
April 2010
March 2010
February 2010
January 2010
December 2009
November 2009
October 2009
September 2009
August 2009
July 2009
June 2009
May 2009
April 2009
March 2009
February 2009
January 2009
December 2008
November 2008
October 2008
September 2008
August 2008
July 2008
June 2008
May 2008
April 2008
March 2008
February 2008
January 2008
December 2007
November 2007
October 2007
September 2007
August 2007
July 2007
June 2007
May 2007
April 2007
March 2007
February 2007
January 2007
December 2006
November 2006
October 2006
September 2006
August 2006
July 2006
June 2006
May 2006
April 2006
March 2006
February 2006
January 2006
December 2005
November 2005
October 2005
September 2005
August 2005
July 2005
June 2005
May 2005
April 2005
March 2005
February 2005
January 2005
December 2004
November 2004
October 2004
September 2004
August 2004
July 2004
June 2004
May 2004
April 2004
March 2004
February 2004
January 2004
December 2003
November 2003
October 2003
September 2003
August 2003
July 2003
June 2003
May 2003
April 2003
March 2003
February 2003
January 2003
December 2002
November 2002
October 2002
September 2002
August 2002
July 2002
June 2002
May 2002
April 2002
March 2002
February 2002
January 2002
December 2001
November 2001
October 2001
September 2001
August 2001
July 2001
June 2001
May 2001
April 2001
March 2001
February 2001
January 2001
December 2000
November 2000
October 2000
September 2000
August 2000
July 2000
June 2000
May 2000
April 2000
March 2000
February 2000
January 2000
December 1999
November 1999
October 1999
September 1999
August 1999
July 1999
June 1999
May 1999
April 1999
March 1999
February 1999
January 1999
December 1998
November 1998
October 1998
September 1998
August 1998
July 1998
June 1998
May 1998
April 1998
March 1998
February 1998
January 1998
December 1997
November 1997
October 1997
September 1997
August 1997
July 1997
June 1997
May 1997
April 1997
March 1997
February 1997
January 1997
December 1996
November 1996
October 1996
September 1996
August 1996
July 1996
June 1996
May 1996
April 1996
March 1996
February 1996
January 1996
December 1995
November 1995
October 1995
September 1995
August 1995
July 1995
June 1995
May 1995

ATOM RSS1 RSS2



LIST.UVM.EDU

CataList Email List Search Powered by the LISTSERV Email List Manager