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KMID : 1147320140010010024
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Journal of Surgical Ultrasound
2014 Volume.1 No. 1 p.24 ~ p.26
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Arterial Stenosis and Occlusion
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Joh Jin-Hyun
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Abstract
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The noninvasive vascular laboratory, in combination with the history and physical examina-tion, plays a critical role in providing an objective diagnosis of lower extremity arterial oc-clusive disease. Duplex scanning is the central part of the vascular laboratory for diagnosis of arterial stenosis and occlusion. Duplex scanning provides detailed anatomic and hemody-namic information from the abdominal aorta to the distal tibial arteries. A standard duplex ultrasound system with high-resolution B-mode imaging, pulsed Doppler spectral waveform analysis, and color-flow imaging is adequate for lower extremity arterial scanning. Low-fre-quency (2- or 3-MHz) transducers are best for evaluation of the iliac arteries, whereas a higher frequency (5- or 12-MHz) transducer is adequate in most patients for infra inguinal vessels. A 50% reduction in arterial diameter (equivalent to a cross-sectional area reduction of 75%) is associated with an increase of peak systolic velocity (PSV). The PSV ratio, divid-ing the maximum velocity within a stenosis by the peak velocity in a normal arterial segment just proximal to the stenosis, is also useful for grading the severity of stenosis. A velocity ra-tio of 2.0 or greater is a reasonable compromise and is used by many vascular laboratories as a threshold for a 50% or greater peripheral arterial stenosis. In conclusion, duplex scanning enables anatomic, physiologic assessment of lower extremity arterial stenosis and occlusion and provides a scientific basis for modern therapeutic approaches to the care of patients with arterial occlusive disease.
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KEYWORD
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Stenosis, Occlusion, Duplex ultrasound
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