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Makes sense!
________________________________
From: UVM Flownet on behalf of Terry Zwakenberg
Sent: Thu 5/28/2009 2:09 PM
To: [log in to unmask]
Subject: Re: arterial duplex criteria
it doesn't thats why the 2 to 1 and 4 to 1 ratios are not employed at that location.
it is also why the primary purpose of the ica/cca ratio is confirmatory not the primary diagnostic criteria. it only overrides the absolute velocity criteria in the presence of pump dysfunction.
...TJ
To handle yourself, use your head. To handle others, use your heart.
On Thu, May 28, 2009 at 12:42 PM, Combs, Kristin <[log in to unmask]> wrote:
Well then, what about in the ICA where the ratio is part of the diagnostic criteria, but the ICA stenosis is almost always at the proximal portion. ?Where does the continuity rule apply there?
________________________________
From: UVM Flownet on behalf of Terry Zwakenberg
Sent: Thu 5/28/2009 11:37 AM
To: [log in to unmask]
Subject: Re: arterial duplex criteria
you can't calculate a ratio based on flow in the CFA compared to flow in the SFA. ratios are only applicable in a situation where the continuity rule applys. in your scenario flow from the CFA has optional pathways so the continuity rule does not apply.
...TJ
To handle yourself, use your head. To handle others, use your heart.
On Thu, May 28, 2009 at 11:27 AM, Smith, Matthew G. <[log in to unmask]> wrote:
Jeff,
Well my first question would be does it look stenotic? Is there plaque present with visible narrowing? If so, that points to 50-75% stenosis. If not, it may not be hemosig. Ratios are a good tool but other duplex info should always be considered before calling something stenotic. ie: if you obtain a velocity of 50cm/s in the CFA and obtain a 120cm/s velocity at the origin of the SFA, and there is no evidence of significant plaque, I wouldn't call a 50-75% stenosis based on the ratio alone. Many times, Doppler waveforms downstream from a mild to moderate stenosis won't change much, so you can't rely on waveform changes alone to quantify the degree of stenosis.
matt
-----Original Message-----
From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Jeff Stanley
Sent: Thursday, May 28, 2009 11:32
To: [log in to unmask]
Subject: Re: arterial duplex criteria
What do you do when you have a velocity ratio of, say 2.4, and flow
remains multiphasic distally (with reversed flow component) and ABI is
1.1?
Jeff
-----Original Message-----
From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Ann
Marie Kupinski
Sent: Thursday, May 28, 2009 8:26 AM
To: [log in to unmask]
Subject: Re: arterial duplex criteria
Hi Kristin,
I have used the criteria that were mentioned along any segment of the
upper or lower extremities.
If I notice a small elevation in velocity but it stays less than a 2:1
ratio, then I report a less than a 50% stenosis.
A 2:1 ratio but less than a 4:1 ratio equals a 50% - 75% stenosis A
greater than 4:1 ratio equals a greater than 75% stenosis
This has worked well for me in small radial arteries, tibial vessels as
well as the CFA, SFA, etc.
I think these ratio criteria are better to use than an absolute
velocity.
The peak velocity does vary depending on a lot of factors so ratios seem
to be more consistent.
Ann Marie Kupinski
Albany, NY
-----Original Message-----
From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Combs,
Kristin
Sent: Thursday, May 28, 2009 8:35 AM
To: [log in to unmask]
Subject: Re: arterial duplex criteria
Can we get back to the question of arterial duplex criteria? I really
am interested in knowing what people are using, or if they are modifying
to new standards......DO you correlate infrapopliteals with < or >
50%???
________________________________
From: UVM Flownet on behalf of Don Ridgway
Sent: Wed 5/27/2009 6:15 PM
To: [log in to unmask]
Subject: Re: arterial duplex criteria
They were very nice folks,I admired their work, and they are no longer
with us. I suppose it's a borderline problem, so I sort of apologize.
Don
-----Original Message-----
From: UVM Flownet on behalf of Doug Marcum
Sent: Wed 5/27/2009 2:28 PM
To: [log in to unmask]
Subject: Re: arterial duplex criteria
Isn't that a HIPPA violation? :)
Doug Marcum RDMS,RDCS,RVT(APS)
Advanced Ultrasound Consultants
Elite Solutions for Vein Therapy/ Insufficiency Scanning and On-Site
Education
P: 321.231.2191
F: 407-971-4775
www.advancedusconsultants.com <http://www.advancedusconsultants.com/> <http://www.advancedusconsultants.com/>
[log in to unmask]
Sent from my iPhone
On May 27, 2009, at 5:18 PM, Don Ridgway <[log in to unmask]> wrote:
> My then co-worker Kathleen Bower got to do a carotid scan on John
> Carradine (Stagecoach, preacher in Grapes of Wrath, hundreds of other
> movies, father of those other Carradines). And we took care of Olaf
> Wieghorst (very highly-regarded Western artist) and his wife.
>
> But the folks across town at Scripps Green did Mother Theresa, so they
> all kind of glow now.
>
> Once when I visited Jean at Cedars, we saw Stewart Granger walking
> along in a bathrobe. I think you have to be pretty old to care about
> him (or John Carradine) unless you watch a lot of TCM channel.
>
> Don Ridgway
>
>
>
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