Thanks Colleen. That is most helpful.
Personally I will add that I have never liked the bunny ears terminology. I always suggest that we simply describe the waveform that is present in the most accurate way we can. For example: "antegrade flow with rapid systolic upstroke with early systolic flow deceleration and transient diastolic reversal" or whatever you happen to see. That description can then be interpreted and its implication determined much more readily than bunnies.
Have a good Friday and a great weekend everyone.
Bill
William B Schroedter, BS, RVT, RPhS, FSVU
4120 Woodmere Park Blvd
Suite 8B
Venice, Florida 34293
www.virtualvascularlab.com
-----Original Message-----
From: UVM Flownet <[log in to unmask]> On Behalf Of Douville, Colleen M
Sent: Thursday, November 1, 2018 6:19 PM
To: [log in to unmask]
Subject: Re: Pre-Steal Vertebral Waveform
Attached is the original article describing the hemodynamic changes that occur with varying degrees of subclavian stenosis (pre duplex and pre spectral analysis), from 1978.
He recommends using the following:
Complete steal: flow reversal throughout the cardiac cycle Incomplete steal: 1) Transient - vertebral artery flow reversed in systole, normal direction in diastole (alternating flow)
2) Latent - vertebral artery flow has normal, antegrade direction but systole is reduced, causing the unusual waveform described as bunny ears.
This work has been repeated and confirmed but thought you might enjoy seeing the early, detailed explanation.
Colleen
Colleen Douville
Director l Vascular Ultrasound & Neurophysiology [log in to unmask]
Office: 206-320-4080
Cell: 206-601-8077
Swedish Neuroscience Institute
500 17th Ave l 4 West, Room 400
Seattle l WA l 98122
-----Original Message-----
From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Mo
Sent: Thursday, November 01, 2018 3:04 PM
To: [log in to unmask]
Subject: Pre-Steal Vertebral Waveform
How do you describe a pre-steal "bunny ear" vertebral waveform? Our physician doesn't approve of us using pre-steal to describe the waveform. She describes that term as being a diagnoses on preliminary reports.
Is there a better descriptor for the waveform other than pre-steal?
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