Abdominal Aorta: Sonograph Evaluation and Disease

Question 1

To obtain a view of both iliac arteries at the bifurcation use a

Answer 1

lateral or coronal approach. It may also be helpful to place the patient in the decub position.

Question 2

Aortic Doppler

Answer 2

Note the reduction in antegrade diastolic flow in the distal aorta. The proximal aortic segment supplies several low resistance vascular beds (liver, spleen, kidneys) that require continuous antegrade flow throughout the cardiac cycle.
The distal aortic segment supplies mostly high resistance vascular beds (extremities).

Question 3

Coraction

Answer 3

Congenital narrowing of the aorta.

Most commonly occurs distal to the origin of the left subclavian.

Question 4

Embolic Sources

Answer 4

Thrombus in an Aneurysm.
Air bubble with vessel puncture.
Atherosclerotic material in an artery
Atherosclerotic material on a heart valve.
Thrombus in a vein.
Cardiac Arrhythmia- paroxysmal atrial fibrillation can cause thromboembolism.
Cardiac tumors.

Question 5

Embolization

Answer 5

Plaque breaks off from vessel wall and travels to distal vessels that are smaller in caliber where it causes obstruction of lfow and ischemia

Question 6

Dissection

Answer 6

Intima may tear due to turbulent flow caused by plaque formation. Intimal flap obstructs flow and causes thrombus formation.
The false lumen created by the intimal flap can fill with thrombus which leads to stenosis.

Question 7

Leriche Syndrome

Answer 7

AKA aortoiliac occlusive disease. Due to occlusion of the abdominal aorta just above the site of its bifurcation.
Low resistance, post - stenotic flow changes throughout both legs.

Question 8

Retroperitoneal Fibrosis

Answer 8

AKA Ormond disease.
Most commonly occurs at the level of the aortic bifurcation and inferiorly in pelvis.
Idiopathic (usually) overgrowth of fibrous tissue around an atherosclerotic aorta.
May compress the IVC causing bilateral pedal edema.
May compress the gonadal veins causing scrotal swelling.