Visceral vascular Flashcards
>= 60% renal artery stenosis
velocity >= 180-200 cm/sec
RAR > 3.5
RAR > 3.5
suggests 60% stenosis
>= 60% renal artery stenosis
velocity >= 180-200 cm/sec
RAR > 3.5
limitations of RAR (renal artery/aorta ratio)
unreliable if aortic velocity > 100 cm/sec or < 40 cm/sec
angle for resistive indices
0
resistive indices
usually hilar vessels
borderline resistive index
0.7-0.79
(higher for renal transplant 0.8)
elevated RI in renal transplant
rejection
ATN
nephrotoxic drug effects
renal vein thrombosis
external compression
criteria for renal artery stent stenosis
> 280 cm/sec
RAR > 4.5
criteria for renal transplant stenosis
> 200 cm/sec with turbulence
renal artery/iliac ratio > 1.8
elevated RI in renal transplant
rejection
ATN
nephrotoxic drug effects
renal vein thrombosis
external compression
celiac artery velocity
100-120 cm/sec

preprandial SMA

triphasic,
pulsatile,
reversal below baseline
post prandial SMA

hyperemic,
more diastolic flow,
above baseline
Celiac stenosis >70%
PSV > 200 cm/sec,
EDV > 100 cm/sec bruit,
turbulence,
spectral broadening
dampened hepatic and splenic arteries
SMA stenosis > 70%
PSV >= 275 cm/sec
EDV > 70 cm/sec
median arcuate artery syndrome worsens with

exhalation

median arcuate syndrome improves with
inhalation and sitting up
measurement portal vein in portal HTN, CHF
> 13 mm though up to 16 mm in inspiration
pulsatile portal vein
CHF
normal portal vein velocity
18-30 cm/sec -
low resistance
hepatic artery velocity
100 cm/sec
low resistance

IVC flow patterns
pulsatile near liver phasic near iliac veins
TIPS velocity
70-220 cm/sec (NAVIX)
100-190 cm/sec (Size Lozanski)
bad TIPS velocity
< 50 cm/sec
< 33% of baseline
drop by 50 cm/sec
sign of abnormal TIPS
narrowing
focal velocity increase
nonpulsatile continuous flow
decreased velocity < 50
drop velocity > 50 vs baseline
absence of flow
gradient > 50 in shunt
retrograde flow right portal vein
decreased portal vein velocity < 33% baseline
IMA resistance
HIGH
median arcuate
diaphragmatic crura celiac artery
when obtaining abnormal celiac artery velocity
to exclude median arcuate syndrome,
obtain velocity in inspiration
nutcracker syndrome
left renal vein thrombosis/compression
venous dilation up to 5 times at point of entrapment
venous velocities up to 5 times greater than at hilum
resistive index
(PSV-EDV)
PSV
celiac artery occlusion
no flow in celiac
retrograde flow in hepatic artery
dampened flow in splenic artery
celiac stenosis > 70%

watch for dampened waveforms
in hepatic & splenic arteries
Doppler bruit
distal turbulence
spectral broadening
renal artery waveforms
