Ultrasound of the Renal Arteries
|
|
|
- Dustin McCormick
- 5 years ago
- Views:
Transcription
1 Ultrasound of the Renal Arteries Greg Curry Vascular Ultrasound Workshop Aug 2017
2 The Examination Technique Pathophysiology Role of US then and now Background Live Scanning Ultrasound
3 Population: 20% Hypertensive Increase risk: Heart attack/stroke <1-5% Renovascular cause Renal Artery stenosis (RAS) RAS Renal failure Need: Screening Test!
4 Pathophysiology
5 Pathophysiology RAS Hypertension Decrease blood volume Enzyme renin is secreted Activates angiotensin mechanism Salt / H20 retention Increase in blood volume Vasoconstriction Accessory RA Intrarenal Vessels
6 Pathophysiology Atherosclerosis Fibro-Muscular Dysplasia (FMD) Mid sized vessels Non-atherosclerotic Non-inflammatory Abnormal intimal growth Inflammatory
7 EVERYONE GETS A STENT Background
8 Key Points We now know that Unselected stenting does not improve outcomes Degree of renal artery stenosis is not the most important determinant of outcome (Ritchie et al 2014) Why do we bother looking for RAS? Better medical management May still be influenced by the presence and severity of RA disease Intervention? Flash pulmonary edema Preserving of Kidney Function
9 Background Nuc. Med DPTA, Mag 3? >90% sens. spec. MRA >95% sens. spec. Knopp, 1999 CT Angio 90-98% sens. spec. Prokop,1999 Angiography % est. gold standard Ultrasound?
10 Background RESISTANT HT Clinical Index of Suspicion Resistant HT Low/Moderate High Continued high blood pressure At least 3 antihypertensive agents Negative Colour Doppler Ultrasound?? Positive Functional Testing Captopril Renal Scan Renal Vein Renin Angiography (+/-PTA Stenting) Stop MRA /CTA
11 The Dilemma Intrinsic Limitations Bowel gas Patient size, respiration Vessel Location, Tortuosity, Ca++ Good Technique can improve our chances (later)
12 The Examination DIRECT INDIRECT Local protocols
13 US technique Direct-Yes Kohler 1986, Moneta 1988, Direct- No Kletter 1990, Desberg 1990, Berland 1990 DIRECT INDIRECT Indirect-Yes Handa 1988 Stavros 1992 Indirect- No Kliewer 1993 etc Direct- Olin Annals of Int Medicine : % sensitivity, 98% spec
14 US technique RI >0.8 Rademacher INDIRECT Resistive Indices Acceleration times Waveform shape RI = PSV-EDV/ PSV 5950 patients 138 angioplasty/ stenting Post Sx. Creatine clearance / Blood pressure 34/35 RI >0.8 V. poor outcome 74/80 RI< 0.8 Good outcome
15 1. Direct RA assessment V good when visualisation Visualisation improving 2. Intrarenal Very easy Still has a role as Marker Functional stenosis If intervention planned Predicts Success
16 The Examination
17 DIRECT Approx 75% visualisation in literature higher Technical Limitations B-mode (?atherosclerosis/ca2++) Colour (?Focal aliasing) Local Protocol
18 DIRECT 64 yo male Hypertensive PSV AA= 58 cm/s PSV RRA= 295 cm/s RAR > 3:1
19 60 yo male Hypertensive Hx of RAS Bil RA stents DIRECT
20 60 yo male Hypertensive Hx of RAS Bil RA stents DIRECT
21 INDIRECT Waveform Shape Tardus Parvus Resistive Indices Superior, mid, inferior
22 INDIRECT Early Systolic Peak AT > 0.07sec AI < 3.0 Variation RI > 0.05 AI = ΔV \ ΔT RI = PSV-EDV/ PSV ΔV ΔT
23 INDIRECT Normal Abnormal Early Systolic Peak Tardus Parvus
24 Early Systolic Peak INDIRECT
25 INDIRECT Normal/ Abnormal? 33yo woman Severe hypertension
26 INDIRECT FMD 33yo woman Severe hypertension
27 INDIRECT Normal/ Abnormal? 21yo female Severe hypertension Hx of Takayasu Arteritis
28 INDIRECT Occluded RA - Collaterals 21yo female Severe hypertension Hx of Takayasu Arteritis
29 21yo female Severe hypertension Hx of Takayasu Arteritis INDIRECT
30 INDIRECT Normal/ Abnormal? 55yo Male Acute severe hypertension
31 55yo Male BMI++ Acute severe hypertension INDIRECT
32
33 The Examination 1. Renal Ultrasound 2. Intrarenal evaluation 3. Main Renal A. 4. Accessory Renal A 5. Aorta: PSV level of SMA 6. Worksheet
34 The Examination
35 0 = Non visualisation, No Spectral 1 = V. poor colour, Angle Uncertainty 5 Grades 0,1 = Sub- optimal examination 2 = Segmental colour, Angle certainty 3 = Full colour visualisation, Angle certainty 4 = As per 3 + Colour enabling assessment of aliasing
36 The Examination Important 5mins B-mode 5 mins Intrarenal 20 mins Direct
37 The Examination Renal Size > 9.0 cm > 2.5cm difference Cortical volume Co-existent pathology
38 The Examination Lobules Cortical Rim Medullary Pyramid Calyces (not seen) Capsule Cortex Sinus fat Pelvic-calyceal
39 The Examination
40 The Examination SET UP IMPORTANT ENLARGE IMAGE FAST SWEEP SPEED REDUCE SCALE NO FILTER
41 The Examination 10 windows- Rt 5, Lt 5 Gentle Compression B-mode! Dynamic Range Transducer Frequency Fasted! Other parameters: Filters Persistence Power etc
42 The Examination 20% of kidneys? Prevalence of isolated ARA stenosis Windows > 50 % visualisation
43 R4 view Coronal view
44 The 10 MAGIC WINDOWS ASA March 2002 Ask the Experts section Renal Arteries by Peter Coombs
45 The Examination
46 US has important role in screening Less common test Integrate: Intrarenal/ Extrarenal Intrarenal debate Emphasis on Direct Structured technique: Windows = Success
Duplex Ultrasound of the Renal Arteries. Duplex Ultrasound. In the Beginning
Duplex Ultrasound of the Renal Arteries DIMENSIONS IN HEART AND VASCULAR CARE 2013 PENN STATE HEART AND VASCULAR INSTITUTE ROBERT G. ATNIP MD PROFESSOR OF SURGERY AND RADIOLOGY Duplex Ultrasound Developed
Transducer Selection. Renal Artery Duplex Exam. Renal Scan. Renal Scan Echogenicity. How to Perform an Optimal Renal Artery Doppler Examination
How to Perform an Optimal Renal Artery Doppler Examination Director of Ultrasound Education & Quality Assurance Baylor College of Medicine Division of Maternal-Fetal Medicine Maternal Fetal Center Imaging
Renal Artery Ultrasound
Ask the Expert Renal Artery Ultrasound Looking for windows of opportunity... by Peter Coombs AMS Peter Coombs is Co-ordinator of the Graduate Diploma of Ultrasound at Monash University, Melbourne. Dear
US of Renovascular Hypertension. Jonathan R. Dillman, MD, MSc Associate Professor Director, Thoracoabdominal Imaging
US of Renovascular Hypertension Jonathan R. Dillman, MD, MSc Associate Professor Director, Thoracoabdominal Imaging Disclosures Nothing Relevant Unrelated grant funding Siemens US Toshiba US Objectives
11 TH ANNUAL VASCULAR NONINVASIVE TESTING SYMPOSIUM NOVEMBER 10, 2018
11 TH ANNUAL VASCULAR NONINVASIVE TESTING SYMPOSIUM NOVEMBER 10, 2018 RENAL ARTERY DISEASE AND RENOVASCULAR HYPERTENSION 1 WHAT IS RENOVASCULAR HYPERTENSION? https://my.clevelandclinic.org/health/diseases/16459-renovascular-hypertension
Abdominal Doppler Mastering the next level of vascular anatomy in the belly. Cindy A. Owen, RDMS, RVT
Abdominal Doppler Mastering the next level of vascular anatomy in the belly Cindy A. Owen, RDMS, RVT Introduction Abdominal Doppler is a tough exam Success is dependent on: Patient body habitus Patient
Diagnosis of Renal Artery Stenosis (RAS)
May 2001 Diagnosis of Renal Artery Stenosis (RAS) Kurt Fink, Harvard Medical School, Year III Epidemiology Hypertension -Affects 60 million Americans Essential HTN >95% of cases Secondary HTN 1-5% of cases
Case 8038 Renal allograft complicated with renal artery stenosis
Case 8038 Renal allograft complicated with renal artery stenosis Santiago I, Canelas A, Pinto AP Section: Cardiovascular Published: 2009, Nov. 30 Patient: 61 year(s), male Clinical History A 61-year-old
MESENTERIC ISCHEMIA. Phillip J Bendick, PhD
MESENTERIC ISCHEMIA Phillip J Bendick, PhD Arterial Celiac - Hepatic - Splenic Superior Mesenteric Artery Inferior Mesenteric Artery Venous Mesenteric system Porto - hepatic system Inferior Vena Cava Acute
Renal artery stenosis
Renal artery stenosis Dr. Alexander Woywodt Consultant Renal Physician, Royal Preston Hospital Preston, 31.10.2007 Menu anatomy of the renal arteries diseases of the large renal arteries atherosclerotic
Evaluation of Colour Duplex Ultrasound Scanning in Diagnosis of Renal Artery Stenosis, Compared to Angiography: A Prospective Study on 53 Patients
Eur J Vasc Endovasc Surg 14, 305-309 (1997) Evaluation of Colour Duplex Ultrasound Scanning in Diagnosis of Renal Artery Stenosis, Compared to Angiography: A Prospective Study on 53 Patients M. Mollo,
Vascular Sonography Examination
Vascular Sonography Examination The purpose of The American Registry of Radiologic Technologists (ARRT ) Vascular Sonography Examination is to assess the knowledge and cognitive skills underlying the intelligent
No financial or commercial relationships to disclose
Deanna New, RVT No financial or commercial relationships to disclose IAC REQUIREMENTS: The main duty of a sonographer is to make the physician or radiologists job easier by capturing images and doing
What effects will proximal or distal disease have on a waveform?
Spectral Doppler Interpretation Director of Ultrasound Education & Quality Assurance Baylor College of Medicine Division of Maternal-Fetal Medicine Maternal Fetal Center Imaging Manager Texas Children
Visceral Vascular Ultrasound. Joel Thompson, MD, MPH Borg & Ide Imaging
Visceral Vascular Ultrasound Joel Thompson, MD, MPH Borg & Ide Imaging Objectives: Review major abdominal vascular structures Identify normal peak systolic velocity (PSV) for major abdominal arteries.
STRUCTURED EDUCATION REQUIREMENTS IMPLEMENTATION DATE: JULY 1, 2016
STRUCTURED EDUCATION REQUIREMENTS Vascular Sonography The purpose of structured education is to provide the opportunity for individuals to develop mastery of discipline-specific knowledge that, when coupled
Vascular Imaging in the Pediatric Abdomen. Jonathan Swanson, MD
Vascular Imaging in the Pediatric Abdomen Jonathan Swanson, MD Goals and Objectives To understand the imaging approach, appearance, and clinical manifestations of the common pediatric abdominal vascular
Image Formation (10) 2 Evaluation and Selection of Representative Images (10)
STRUCTURED SELF ASSESSMENT CONTENT SPECIFICATIONS SSA LAUNCH DATE: JANUARY 1, 2018 Vascular Sonography The purpose of continuing qualifications requirements (CQR) is to assist registered technologists
What effects will proximal or distal disease have on an waveform?
Spectral Doppler Interpretation Director Director of of Ultrasound Ultrasound Education Education & & Quality Quality Assurance Assurance Baylor Baylor College College of of Medicine Medicine Division
NON-ATHEROSCLEROTIC PATHOLOGY OF THE CAROTID ARTERIES
NON-ATHEROSCLEROTIC PATHOLOGY OF THE CAROTID ARTERIES Leslie M. Scoutt, MD, FACR Professor of Diagnostic Radiology & Surgery Vice Chair, Dept of Radiology & Biomedical Imaging Chief, Ultrasound Section
Beyond Stenosis Severity: Top 5 Important Duplex Characteristics to Identify in a Patient with Carotid Disease
Beyond Stenosis Severity: Top 5 Important Duplex Characteristics to Identify in a Patient with Carotid Disease Jan M. Sloves RVT, RCS, FASE Technical Director New York Cardiovascular Associates Disclosures
Ultrasound Imaging of The Posterior Circulation
Ultrasound Imaging of The Posterior Circulation Michigan Sonographers Society 2 Nd Annual Fall Vascular Conference Larry N. Raber RDMS-RVT Clinical Manager General Ultrasound/Neurovascular Laboratory Cleveland
Sonography in Renovascular Hypertension
Review rticle Sonography in Renovascular Hypertension Hsin-Yi Lee, MD, Edward G. Grant, MD Objective. To familiarize practitioners with different sonographic manifestations of renal artery compromise and
HD Scanning: Velocities and Volume Flow
HD Scanning: Velocities and Volume Flow Non-Invasive Lab Symposium West Orange, NJ April 27, 2018 Volume Flow Cindy Sturt, MD, FACS, RVT 500,000 Americans on dialysis 20-25% annual mortality 65% 5 year
Renal Artery Disease. None > 65,000,000. Learning objectives: Renal Artery Disease
Renal Artery Disease Robert D. McBane, M.D. Division of Cardiology Mayo Clinic Rochester Financial Disclosure Information Renal Artery Disease Robert McBane, MD None To appreciate: Learning objectives:
What Do We Know? Disclosure Statement: 3/11/2015. Deep abdominal imaging
Marsha M. Neumyer, BS, RVT, FSVU, FSDMS, FAIUM International Director Vascular Diagnostic Educational Services Vascular Resource Associates Harrisburg, PA Disclosure Statement: CME Calendar QR Code Marsha
Coral Trials: A personal experience that challenges its results in patients with uncontrolled blood pressure.
Coral Trials: A personal experience that challenges its results in patients with uncontrolled blood pressure.. Dr. Javier Ruiz Aburto, FACS, FICS Assistant Professor Ponce School of Medicine Puerto Rico
Goals. Access flow and renal artery stenosis evaluation by Doppler ultrasound. Reimbursement. WHY use of Doppler Ultrasound
Access flow and renal artery stenosis evaluation by Doppler ultrasound Adina Voiculescu, MD Interventional Nephrology Brigham and Women s Hospital Boston Instructor at Harvard Medical School Understand
8/20/18. The Doppler Effect. Objectives. What is the Doppler Effect. Doppler principles. Spectral Waveform. Image recognition. Vascular Ultrasound
Vascular Ultrasound: Physics and Haemodynamics Objectives Doppler principles Spectral Waveform Key factors Haemodynamics: Stenosis Waveforms Image recognition Vascular Ultrasound: A flawed paradigm What
Renal Doppler Hospital Based Study and Review of Literature
ORIGINAL RESEARCH www.ijcmr.com Hospital Based Study and Review of Literature Jahangeer Ahmad Bhat 1, Murassa Shamshad 2, Aresalan Malik 1, Iqbal Bhat 3, Iqbal Dar 3 ABSTRACT Introduction: Study was done
AIUM Practice Guideline for the Performance of Renal Artery Duplex Sonography
AIUM Practice Guideline for the Performance of Renal Artery Duplex Sonography 2008 by the American Institute of Ultrasound in Medicine The American Institute of Ultrasound in Medicine (AIUM) is a multidisciplinary
Vascular Surgery Cases: Detours. Brian F. Stull, RDMS, RVT UNC REX Healthcare Vascular Specialists
Vascular Surgery Cases: Detours Brian F. Stull, RDMS, RVT UNC REX Healthcare Vascular Specialists Brian.Stull@Unchealth.unc.edu Objectives Anatomy of a bypass graft Where does it connect, where does it
Current Role of Renal Artery Stenting in Patients with Renal Artery Stenosis
Current Role of Renal Artery Stenting in Patients with Renal Artery Stenosis Young-Guk Ko, M.D. Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea Etiology Fibromuscular
Renal. Prof John Buscombe
Renal Prof John Buscombe Renal nuclear Medicine Only consistent test of kidney func7on Many good tests for renal anatomy Ultrasound good looking at cysts and renal pelvis CT can look at perfusion, size
This is not FMD! Fibromuscular Dysplasia Diagnosis, Treatment and Surveillance. Disclosures
Disclosures Advisor: Innovein, inc Fibromuscular Dysplasia Diagnosis, Treatment and Surveillance Marlene Grenon, MD Department of Surgery April 2017 40 year-old woman referred for arm and leg weakness
Colour Doppler sonography to screen for renal artery stenosistechnical
2385 Colour Doppler sonography to screen for renal artery stenosistechnical points to consider B. Krumme and L. C. Rump University Hospital Freiburg, Department of Internal Medicine, Freiburg, Germany
Renal Artery Stenosis With Severe Hypertension: A Case Report
CASE REPORT Renal Artery Stenosis With Severe Hypertension: A Case Report Suwaid MA ABSTRACT Background: Renal artery stenosis (RAS) is found in 77% of hypertensive patients and is responsible for 1-2%
Systemic Hypertension
BCS Theme Session Cardiovascular Block Pathology of Hypertension Department of Pathology University of Sydney Systemic Hypertension Definition of Systemic hypertension: consistent blood pressure elevation
Recommendations for Follow-up After Vascular Surgery Arterial Procedures SVS Practice Guidelines
Recommendations for Follow-up After Vascular Surgery Arterial Procedures 2018 SVS Practice Guidelines vsweb.org/svsguidelines About the guidelines Published in the July 2018 issue of Journal of Vascular
Renovascular hypertension in children and adolescents
Renovascular hypertension in children and adolescents M I E C Z Y S L AW L I T W I N D E P T. O F N E P H R O LO G Y & A R T E R I A L H Y P E R T E N S I O N T H E C H I L D R E N S M E M O R I A L H
1. How did occlusion of Mr. Hanna's left renal artery lead to an increase in plasma renin activity?
76 I'HYSIOLOGY CASES AND PROBLEMS Case 14 Renovascular Hypertension: The Renin-Angiotensin-Aldosterone System Stewart Hanna is a 58-year-old partner in a real estate firm. Over the years, the pressures
DISCLOSURE TEST YOUR WAVEFORM IQ. Partial volume artifact. 86 yo female with right arm swelling, picc line. AVF on left? Dx?
Deborah Rubens University of Rochester Rochester, NY DISCLOSURE Neither I nor my immediate family have a financial relationship with a commercial organization that may have a direct or indirect interest
Pre-and Post Procedure Non-Invasive Evaluation of the Patient with Carotid Disease
Pre-and Post Procedure Non-Invasive Evaluation of the Patient with Carotid Disease Michael R. Jaff, D.O., F.A.C.P., F.A.C.C. Assistant Professor of Medicine Harvard Medical School Director, Vascular Medicine
Radiologic Evaluation of Peripheral Arterial Disease
January 2003 Radiologic Evaluation of Peripheral Arterial Disease Grace Tye, Harvard Medical School Year III Patient D.M. CC: 44 y/o male with pain in his buttocks Occurs after walking 2 blocks. Pain is
The Role of US in Chronic Mesenteric Ischemia. Sagar S. Gandhi, MD Vascular Health Alliance Greenville Health System
The Role of US in Chronic Mesenteric Ischemia Sagar S. Gandhi, MD Vascular Health Alliance Greenville Health System No Disclosures Mesenteric Ischemia Anatomy Presentation Diagnostic tools Treatment Celiac
GUNDERSEN/LUTHERAN ULTRASOUND DEPARTMENT POLICY AND PROCEDURE MANUAL
GUNDERSEN/LUTHERAN ULTRASOUND DEPARTMENT POLICY AND PROCEDURE MANUAL SUBJECT: Carotid Duplex Ultrasound SECTION: Vascular Ultrasound ORIGINATOR: Deborah L. Richert, BSVT, RDMS, RVT DATE: October 15, 2015
Section II: Patient Interview Grade: 5
Only written competency completed with this EXACT form will be accepted for grading. No modifications to the LAYOUT of the form will be accepted for a written competency. Failure to comply will result
Salvageability of renal function following renal revascularization in children with Takayasu arteritis-induced renal artery stenosis
Salvageability of renal function following renal revascularization in children with Takayasu arteritis-induced renal artery stenosis Obiagwu P 1, Gajjar P 1, Scott C 1, Numanoglu A 2, McCulloch M, 1 Nourse
Abdominal Ultrasound : Aorta, Kidneys, Bladder
Abdominal Ultrasound : Aorta, Kidneys, Bladder Nilam J. Soni, MD, MSc Associate Professor of Medicine Divisions of Hospital Medicine and Pulmonary/Critical Care Medicine Department of Medicine University
Subclavian artery Stenting
Subclavian artery Stenting Etiology Atherosclerosis Takayasu s arteritis Fibromuscular dysplasia Giant Cell Arteritis Radiation-induced Vascular Injury Thoracic Outlet Syndrome Neurofibromatosis Incidence
Deb Coghlan AMS (Vascular and General ) Brisbane, Australia
Deb Coghlan AMS (Vascular and General ) Brisbane, Australia ANEURYSMAL DIISEASE The infrarenal aorta enlarges with age, and is the commonest site for arterial aneurysms. An aneurysm is a permanent focal
Secondary Hypertension: A Real World Approach
Secondary Hypertension: A Real World Approach Evan Brittain, MD December 7, 2012 Kingston, Jamaica Disclosures None Real World Causes Renovascular Hypertension Endocrine Obstructive Sleep Apnea Pseudosecondary
Carotid Artery Doppler
Carotid Artery Doppler Patient Position supine or semisupine head slightly hyper extended rotated 45 away from the side being examined. Higher frequency linear transducers (7 MHz) Vessels should be imaged
Imaging of Renovascular. Scintigraphy, Renal Doppler US, and MR Angiography 1
SCIENTIFIC EXHIBIT 1355 Imaging of Renovascular Hypertension: Respective Values of Renal Scintigraphy, Renal Doppler US, and MR Angiography 1 CME FEATURE See accompanying test at http:// www.rsna.org /education
Treatment of choice for end stage renal disease Imaging to establish baseline and diagnosis of potential complications Review common surgical
Treatment of choice for end stage renal disease Imaging to establish baseline and diagnosis of potential complications Review common surgical techniques Review normal appearance Discuss US diagnosis of
Optimising your Doppler settings for an accurate PI. Alison McGuinness Mid Yorks Hospitals
Optimising your Doppler settings for an accurate PI Alison McGuinness Mid Yorks Hospitals Applications Both maternal uterine and fetal circulations can be studied with doppler sonography Uterine arteries
RENAL AND MESENTERIC ARTERY STENTS Are There Standard Velocity Criteria for Restenosis?
RENAL AND MESENTERIC ARTERY STENTS Are There Standard Velocity Criteria for Restenosis? R. Eugene Zierler, M.D. The D. E. Strandness, Jr. Vascular Laboratory University of Washington Medical Center Division
Year 2004 Paper two: Questions supplied by Megan 1
Year 2004 Paper two: Questions supplied by Megan 1 QUESTION 96 A 32yo woman if found to have high blood pressure (180/105mmHg) at an insurance medical examination. She is asymptomatic. Clinical examination
Vascular Ultrasound: Current state, current needs, future directions
Vascular Ultrasound: Current state, current needs, future directions Laurence Needleman, MD Thomas Jefferson University Hospitals Sidney Kimmel Medical College of Thomas Jefferson University Disclosures
Original Article Assessment of diagnostic value of a new Doppler index for renal artery stenosis and comparison with conventional methods
Int J Clin Exp Med 2017;10(6):9513-9517 www.ijcem.com /ISSN:1940-5901/IJCEM0052288 Original Article Assessment of diagnostic value of a new Doppler index for renal artery stenosis and comparison with conventional
1. Long images of aorta (prox, mid, and dist) with AP measurements. 2. Trans images of aorta (prox, mid, and dist) with R/L measurements.
Aorta 1. Long images of aorta (prox, mid, and dist) with AP measurements. 2. Trans images of aorta (prox, mid, and dist) with R/L measurements. 3. Long images of R/L common iliac arteries with AP measurements.
Carotid Abnormalities Coils, Kinks and Tortuosity David Lorelli M.D., RVT, FACS Michigan Vascular Association Conference Saturday, October 20, 2012
Carotid Abnormalities Coils, Kinks and Tortuosity David Lorelli M.D., RVT, FACS Michigan Vascular Association Conference Saturday, October 20, 2012 Page 1 Table of Contents Carotid Anatomy Carotid Duplex
The major issues in approaching patients with renal artery stenosis
Renovascular Hypertension and Ischemic Nephropathy Marc A. Pohl The major issues in approaching patients with renal artery stenosis relate to the role of renal artery stenosis in the management of hypertension,
Basic of Ultrasound Physics E FAST & Renal Examination. Dr Muhammad Umer Ihsan MBBS,MD, DCH CCPU,DDU1,FACEM
Basic of Ultrasound Physics E FAST & Renal Examination Dr Muhammad Umer Ihsan MBBS,MD, DCH CCPU,DDU1,FACEM What is Sound? Sound is Mechanical pressure waves What is Ultrasound? Ultrasounds are sound waves
Imaging Strategy For Claudication
Who are the Debators? Imaging Strategy For Claudication Duplex Ultrasound Alone is Adequate to Select Patients for Endovascular Intervention - Pro: Dennis Bandyk MD No Disclosures PRO - Vascular Surgeon
Radiologic Importance of a High- Resistive Vertebral Artery Doppler Waveform on Carotid Duplex Ultrasonography
CME Article Radiologic Importance of a High- Resistive Vertebral Artery Doppler Waveform on Carotid Duplex Ultrasonography Esther S. H. Kim, MD, MPH, Megan Thompson, Kristine M. Nacion, BA, Carmel Celestin,
A Closer Look: Renal Artery Stenosis. Renal artery stenosis (RAS) is defined as a TOPICS FROM CHEP. Shawn s stenosis
TOPICS FROM CHEP A Closer Look: Renal Artery Stenosis On behalf of the Canadian Hypertension Education Program (CHEP), Dr. Tobe gives an overview of renal artery stenosis, including the prevalence, screening
Abdomen and Retroperitoneum Ultrasound Protocols
Abdomen and Retroperitoneum Ultrasound Protocols Reviewed By: Anna Ellermeier, MD Last Reviewed: March 2018 Contact: (866) 761-4200, Option 1 **NOTE for all examinations: 1. If documenting possible flow
Michael Meuse, M.D. Vascular and Interventional Radiology
Michael Meuse, M.D. Vascular and Interventional Radiology Which patient would likely benefit from renal artery revascularization? Patient A- 60 y/o male with 20 year hx of htn; on 2 drug therapy for 10
Takayasu s arteritis. Justin Mason. Professor of Vascular Rheumatology Imperial College London Hammersmith Hospital
Takayasu s arteritis Justin Mason Professor of Vascular Rheumatology Imperial College London Hammersmith Hospital I have nothing to disclose. Takayasu s clinical features Early phase non-specific features
Vascular Technology Examination Content Outline
Vascular Technology Examination Content Outline (Outline Summary) # Domain Subdomain Percentage 1 Normal Anatomy, Perfusion, and Function Evaluate normal anatomy, perfusion, function 2 Pathology, Perfusion,
7/10/2015. Deborah J. Rubens, MD RENAL DOPPLER IT MAKES THE DIAGNOSIS! DISCLOSURES. Renal Doppler It Makes the Diagnosis!
Renal Doppler It Makes the Diagnosis! None DISCLOSURES Deborah J. Rubens, M.D. Professor of Imaging Sciences, Oncology and Biomedical Engineering University of Rochester Medical Center Associate Director,
How to assess the hemodynamic importance of a renal artery stenosis. Felix Mahfoud, MD Saarland University Hospital Homburg/Saar, Germany
How to assess the hemodynamic importance of a renal artery stenosis Felix Mahfoud, MD Saarland University Hospital Homburg/Saar, Germany How to assess renal artery stenosis severity 1. Non-invasive assessments
Rare Cause of Cephalalgia in a Young Woman - a Case Report
Acta Medica Marisiensis 2015;61(4):382-386 DOI: 10.1515/amma-2015-0045 CASE REPORT Rare Cause of Cephalalgia in a Young Woman - a Case Report Varga Andreea, Szakacs Xantus Timea *, Gliga Mirela, Podoleanu
OPEN ACCESS TEXTBOOK OF GENERAL SURGERY
OPEN ACCESS TEXTBOOK OF GENERAL SURGERY RENOVASCULAR HYPERTENSION NG Naidoo BASIC CONSIDERATIONS Renovascular hypertension (RVH) is defined as any vascular pathology that produces hypoperfusion of the
Original Article. Direct Duplex Scanning Parameters in the Diagnosis of Renal Artery Stenosis: A Study to Validate and Optimize Cut-off Points
Article Original Article Direct Duplex Scanning Parameters in the Diagnosis of Renal Artery Stenosis: A Study to Validate and Optimize Cut-off Points Carla Motta Cardoso 1,2, Sérgio Salles Xavier 1, Gaudencio
My Patient Has Abdominal Pain PoCUS of the Biliary Tract and the Urinary Tract
My Patient Has Abdominal Pain PoCUS of the Biliary Tract and the Urinary Tract Objectives PoCUS for Biliary Disease PoCUS for Renal Colic PoCUS for Urinary Retention Biliary Disease A patient presents
Case Report 1. CTA head. (c) Tele3D Advantage, LLC
Case Report 1 CTA head 1 History 82 YEAR OLD woman with signs and symptoms of increased intra cranial pressure in setting of SAH. CT Brain was performed followed by CT Angiography of head. 2 CT brain Extensive
Abdominal Aortic Aneurysm (AAA)
Abdominal Aortic Aneurysm (AAA) Vascular Workshop: Objectives Anatomy Keith VanHaltren Indications Technique Cases Abdominal Aorta: Normal Size Abdominal aortic aneurysm: Definition Normal diameter of
Fibromuscular Dysplasia (FMD) of the renal arteries Angiographic features and therapeutic options
Fibromuscular Dysplasia (FMD) of the renal arteries Angiographic features and therapeutic options Poster No.: C-0630 Congress: ECR 2012 Type: Educational Exhibit Authors: K. I. Ringe, B. Meyer, F. Wacker,
Imaging for Peripheral Vascular Disease
Imaging for Peripheral Vascular Disease James G. Jollis, MD Director, Rex Hospital Cardiovascular Imaging Imaging for Peripheral Vascular Disease 54 year old male with exertional calf pain in his right
Indications: following: embolization. artery that has diseases 5. The evaluation. of suspected. such entities. a cold hand. biopsy
Peripheral Arterial Ultrasound Protocol Using Color and Spectral Doppler Reviewed by: Mark Yuhasz, MD Last Review Date: January 2015 Contact: (866) 761 4200, Option 1 Indications: The indications for peripheral
Introduction History Preceded by Arterial Doppler and ABI Indications
Elise Brady, RVT, RDMS Introduction History Preceded by Arterial Doppler and ABI Indications 1) Abnormal ABI (within 2weeks of duplex) 2) Abnormal Doppler waveforms 3) Claudication 4) History of PVD 5)
Special Lecture 11/08/2013. Hypertension Dr. HN Mayrovitz
Special Lecture 11/08/2013 Hypertension Dr. HN Mayrovitz Arterial Blood Pressure (ABP) Major Factors Summarized Sympathetic Hormones Arteriole MAP ~ Q x TPR + f (V / C) SV x HR Renal SBP Hypertension =
Lower Extremity Artery: Physiologic Testing
Master Title Ultrasound for Initial Evaluation of Lower Extremity Arterial Occlusive Disease: WHY? Gregory L. Moneta MD Professor and Chief Knight Cardiovascular Institute Division of Vascular Surgery
RENAL ARTERY PTA. JH PEREGRIN IKEM, Prague
RENAL ARTERY PTA JH PEREGRIN IKEM, Prague PTRA/Stenting PTRA technical success rate > 90 % In some patients helps control hypertension In some patients can improve kidney function Serious complications
Evaluation of renal artery stenosis with hemodynamic parameters of Doppler sonography
Evaluation of renal artery stenosis with hemodynamic parameters of Doppler sonography Jian-chu Li, MD, a Yu-xin Jiang, MD, a Shu-yang Zhang, MD, b Lei Wang, MD, c Yun-shu Ouyang, MD, a and Zhen-hong Qi,
Fibromuscular Dysplasia. Miranda Forrest Baker College
Fibromuscular Dysplasia Miranda Forrest Baker College Overview Case Study Patient Information Exam Images Findings FMD Types Signs and Symptoms Treatment Case Study Patient Information Female 57 years
Peripheral Arterial Disease: Who has it and what to do about it?
Peripheral Arterial Disease: Who has it and what to do about it? Seth Krauss, M.D. Alaska Annual Nurse Practitioner Conference September 16, 2011 Scope of the Problem Incidence: 20%
Review of Cardiac Imaging Modalities in the Renal Patient. George Youssef
Review of Cardiac Imaging Modalities in the Renal Patient George Youssef ECHO Left ventricular hypertrophy (LVH) assessment Diastolic dysfunction Stress ECHO Cardiac CT angiography Echocardiography - positives
Transcranial Doppler (Basic Step) Dae-il Chang, M.D., Sung Sang Yoon, M.D. Department of Neurology, College of Medicine, Kyunghee university
Transcranial Doppler (Basic Step) Dae-il Chang, M.D., Sung Sang Yoon, M.D. Department of Neurology, College of Medicine, Kyunghee university Principles of Doppler Ultrasonography Major target Speed & direction
Carotid US: More than just a chart on the wall
Carotid US: More than just a chart on the wall Leslie M. Scoutt, MD, FACR Professor of Diagnostic Radiology & Surgery Vice Chair, Dept of Radiology & Biomedical Imaging Chief, Ultrasound Section Medical
Postoperative AV Fistula Evaluation. Postoperative examination protocol. Postoperative AVF Protocol. Hemodialysis Access Surveillance
Hemodialysis Access Surveillance Postoperative AV Fistula Evaluation Failure of maturation Stenosis Perigraft mass/fluid collection Joseph L. Mills, Sr., M.D. Professor of Surgery Chief, Division of Vascular
Erin Kane, HMS III Dr. Gillian Lieberman BIDMC Radiology Core Clerkship March 2009
Erin Kane, HMS III Dr. Gillian Lieberman BIDMC Radiology Core Clerkship March 2009 Agenda Patient OH: Initial presentation Kidney transplantation: Menu of tests Routine imaging for kidney donors Selected
SCAI Fall Fellows Course Subclavian/Innominate Case Presentation
SCAI Fall Fellows Course 2012 Subclavian/Innominate Case Presentation Daniel J. McCormick DO, FACC, FSCAI Director, Cardiovascular Interventional Therapy Pennsylvania Hospital University of Pennsylvania
CORAL Trial Aftermath: What Do We Do Now? Renal Revascularization in Perspective
CORAL Trial Aftermath: What Do We Do Now? Renal Revascularization in Perspective Michael R. Jaff, DO Massachusetts General Hospital Boston, Massachusetts, USA Michael R. Jaff, DO Conflicts of Interest
Fetal Renal Malformations: The Role of Ultrasound in Diagnosis & Management
Fetal Renal Malformations: The Role of Ultrasound in Diagnosis & Management 12 weeks Alfred Abuhamad, M.D. Eastern Virginia Medical School 13 weeks 2nd trimester Medullary pyramids Renal Sinus Cortex 2nd
Non-Contrast MRA. How and When 1996! Why Non-Contrast MRA? Angiography: What are our goals? Inflow Techniques Differences in excitation hx
A major teaching hospital of Harvard Medical School Angiography: What are our goals? Non-Contrast MRA: How and When Neil M. Rofsky, M.D. Professor of Radiology, Harvard Medical School Director of MRI &
Carotid Duplex: Beyond Stenosis Ido Weinberg, MD Vascular Medicine Massachusetts General Hospital Assistant Professor of Medicine Harvard Medical
Carotid Duplex: Beyond Stenosis Ido Weinberg, MD Vascular Medicine Massachusetts General Hospital Assistant Professor of Medicine Harvard Medical School Boston, Massachusetts Disclosures I do not have
New Trials in Progress: ACT 1. Jon Matsumura, MD Cannes, France June 28, 2008
New Trials in Progress: ACT 1 Jon Matsumura, MD Cannes, France June 28, 2008 Faculty Disclosure I disclose the following financial relationships: Consultant, CAS training director, and/or research grants