Marsha and Don, You are the best and thank you. We all have our ways of doing things and comfort zones. I prefer to stay close to the 35 - 60% areas. I roll the patients in and out of decubitus. I originally did everything with an angle, because I was confident of the angle of the arteries even in the cortex in a transverse scan!!! So you can imagine my thoughts on no angle. No angles were for cardiac CW doppler! I was shocked to see a technician recently use zero angle correction of a tortuous ICA. To me there is an angle in every "s" turn and it should be angle corrected.
I can see going threw a stenosis without an angle on a renal. The key is to walk in real time thru it. We all must use the criteria for a stenosis and trust the years of proven data. A stenosis is a stenosis and the noise, the angle, the velocity, the turbulence and the ratios are there to guide you. Trust it. Thank you Marsha...Kirk Beach thanks and I can heard Dr. Strandness now... I miss him, Denise Levy
On 9/18/07, [log in to unmask] <
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No, you are right. You have to stay with the best angle that you can obtain. Sometimes (not frequently) I cannot obtain an angle between 45 and 60 degrees in the distal to mid segment with the patient in the lateral decubitus position. If I have great difficulty, I might place the patient in the prone position over a pillow or foam wedge to gain advantage on angle correction. In a small minority of cases, I may have to work the entire length of the renal over an angle range from 0 to 30 degrees....I hate those...having grown up in the 45-60 degree years
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