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    Lower extremity arterial duplex ultrasound is used to evaluate peripheral arterial disease and vascular abnormalities from the abdominal aorta down to the foot. It can identify stenosis, occlusions, aneurysms, and other vascular pathology. Proper Doppler optimization including ultrasound angle, color gain, and sample volume are needed to accurately characterize blood flow. Abnormal findings on duplex ultrasound can help guide clinical management of conditions like claudication, ischemia, and follow-up of vascular procedures.

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    Lower extremity arterial duplex ultrasound is used to evaluate peripheral arterial disease and vascular abnormalities from the abdominal aorta down to the foot. It can identify stenosis, occlusions, aneurysms, and other vascular pathology. Proper Doppler optimization including ultrasound angle, color gain, and sample volume are needed to accurately characterize blood flow. Abnormal findings on duplex ultrasound can help guide clinical management of conditions like claudication, ischemia, and follow-up of vascular procedures.

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    11 views41 pages

    LL Arterial

    Uploaded by

    Raihana1987
    Lower extremity arterial duplex ultrasound is used to evaluate peripheral arterial disease and vascular abnormalities from the abdominal aorta down to the foot. It can identify stenosis, occlusions, aneurysms, and other vascular pathology. Proper Doppler optimization including ultrasound angle, color gain, and sample volume are needed to accurately characterize blood flow. Abnormal findings on duplex ultrasound can help guide clinical management of conditions like claudication, ischemia, and follow-up of vascular procedures.

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    of 41

    Lower Extremity Arterial

    BIBIANA TANG, RVT


    E-mail tjiayieng1982@yahoo.com
    Lower Extremity Arterial Duplex
    Evaluation
    PURPOSE
    Duplex ultrasound of the lower extremity arteries is
    performed to provide an overview of the location, extent
    and severity of vascular disease.

    The ultrasound evaluation can be performed from the


    abdominal aorta through the tibial vessels and extended
    into the foot in order to facilitate clinical management
    decisions.
    Indications
     Claudication  Follow-up endovascular
    procedure (e.g., angioplasty,stent)

     Ischemic rest pain


     Bypass graft

     Arterial ulceration  Pseudo-aneurysm

     Peripheral arterial disease  Arterio-venous fistula


    (PAD)

     Hemodialysis access
     Suspected arterial
    embolization
     Trauma
    Limitations

     Lower extremity contractures and/or edema/swelling

     Casts, dressings, open wounds


    Pertinent History

     Diabetes  Obesity

     Hypertension  Cerebrovascular

     Hyperlipidemia
    disease
     Coronary artery
     Age
    disease
     Smoking
     Family history of PAD

    Symptoms
     Claudication  Ischemia

     Rest pain  Hair loss


     Ulceration  Pallor

     Gangrene  Dependent rubor


    Pain Pallor Paraesthesia

    Acute Limb Ischemia

    Paralysis Perishingly Pulselessness


    cold
    US procedure LL arterial

     Inguinal crease
     CFA → SFA → Pop A → PTA, Per A and ATA
     Proximal, mid, distal
     LS, walk the Doppler
     Pre, at, post stenostic
    Anatomy
     Below knee crease.
     The anatomy of LL arteries
    on CT angiography.
     Above the knee crease
    Arteries and Veins in US

    Arteries Veins
     Round  Oval
     Smaller  Larger
     Ticker wall, may  Thin wall
    calcified  compressible
     Not easily compressible
    CFA
    SFA
    CFA bifurcation
    Pop A Tibioperoneal PTA
    trunk
    ATA Dorsalis
    Pedis artery
    Doppler US Optimization

     Color box  Size and location

     Color gain  Sample volume cursor

     Color scale  Doppler angle

     Wall filters
    How to fix this problem?
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    How to fix this problem?
    How to fix this problem?
    How to fix this problem?
    How to fix this problem?
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    How to set the color box?
     make sure the steered ultrasound beam and vessel
    meet an acute angle 60° or less.
    How to fix this problem?
    How to fix this problem?
    Doppler spectrum of Normal Lower
    Extremity Artery
     Waveform
     Flow pattern
     1st phase
     2nd phase
     3rd phase
    Abnormal Doppler US in LL

     Plaque
     Calcification
     Occlusion
     Color flow
     Stenosis
     Adjustment of PW Doppler in stenotic arterial segment. The aliasing
    artifact on Doppler spectrum can be adjusted by lowering the
    baseline and increasing the scale.
     A 56 year-old man with arterial occlusion.
     Color flow is absent in SFA, representing complete occlusion.
    End

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