Deb Coghlan AMS (Vascular and General ) Brisbane, Australia
|
|
- Claud Roderick West
- 5 years ago
- Views:
Transcription
1 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 dilatation and elongation of an artery. An aneurysm may be defined as a 50% increase in diameter compared to the expected normal diameter of the aorta, more practically, when the aortic diameter exceeds 3cm. Abdominal aortic aneurysms (AAAs) primarily affect elderly males (sex ratio 4:1), with a prevalence of up to 5%. Ruptured AAAs are responsible for approximately 1.5% of the total mortality in males over 55 years of age, and the thirteenth commonest cause of death in the Western world. Natural History. A 5cm AAA has a 5-6% per year rupture rate, increasing with the size of the aneurysm up to 25% for a 7cm aneurysm. The rupture rate has been reported to be >50% for aneurysms >7cm. The expansion rate of AAAs is 2-3mm per year, and increases as the aneurysm enlarges. In our practice patients with asymptomatic AAAs <5cm are followed with ultrasound. CT scans are not normally ordered until the aneurysm reaches 5-5.5cm, or if there has been rapid growth of the aneurysm (more than 6mm in 6 months or 10mm in one year). Another rule of thumb is if the aneurysm growth is more than 10% in a year. Although abdominal aneurysms may cause symptoms due to pressure on surrounding structures, approximately 75% remain asymptomatic at initial diagnosis. In recent years the options for repair have changed dramatically with the development of endovascular techniques. Endovascular Aneurysm Repair (EVAR) was introduced by Parodi in the early 1990s and is now the operative approach for over half of AAAs treated in Australia. This is due to the lower post operative mortality rate of EVAR (1-2%) compared to open repair (3-5%) The best results continue to follow carefully planned elective treatment before complications of rupture, thrombosis, or embolism occur. The contrast in mortality between elective surgery (2-5%) and ruptured abdominal aortic aneurysm repair (50-70%) remains one of the most striking examples of the importance of early recognition and proper treatment of aneurysms
2 Types of Aneurysms. A true aneurysm forms as a result of a weakness of the arterial wall structure and it involves all of the layers of the arterial wall. A false or "pseudoaneurysm" is actually a pulsatile contained haematoma formed by the extravasation of blood outside the vessel as a result of a penetrating injury or rupture of a native vessel. The term "ectatic" is used to describe a dilated vessel whose diameter is enlarged but not sufficiently enough to classify it as an aneurysm. Aortic aneurysms may be caused by disorders such as atherosclerosis, mycosis, syphilis, trauma, Takayasu's disease scleroderma, or other idiopathic aortitis Aneurysms are usually described as being either fusiform (cylindrical) or saccular (out pouching involving predominantly a portion of the wall). Aortic dissection most often occurs because of a tear or damage to the inner wall of the aorta. This usually occurs in the thoracic portion of the artery, but may also occur in the abdominal portion.
3 A. OBJECTIVES To determine the location of the aneurysm (infrarenal or suprarenal) To determine the longitudinal, anteroposterior and transverse dimensions of the aneurysm To determine channel patency To determine iliac artery involvement To determine renal artery involvement To evaluate the periaortic region for masses, haemorrhage or adenopathy To identify presence of other lesions, including but not limited to, aortic dissection and pseudoaneurysm. B. INDICATIONS Pulsatile abdominal mass Abdominal bruit Bilateral leg pain or weakness Distal emboli Abdominal, flank or back pain Evaluation of interventional treatments, such as endoluminal stent placements. Follow up of know aortic aneurysms C. CONTRAINDICATIONS AND LIMITATIONS Excessive bowel gas Dressings, sutures, tubes etc Extreme abdominal girth Uncooperative patient D. EQUIPMENT AND SUPPLIES High-resolution real-time imager and integrated, pulsed, range-gated Doppler with colour flow imaging MHz transducer, depending on size of patient. Printer or DICOM for hard copy prints of spectral waveforms and images of vessels. Acoustic gel. Transept cleaning agent or other agent that is acceptable for use with ultrasound equipment. E. PATIENT PREPARATION Patients should be fasted after midnight. However elderly and diabetic patients may have a cup of tea an one piece of toast approximately 3 hrs prior to the examination. Patients may take routine medications. Lab personnel should greet the patient by name and introduce themselves. An interview of the patient should include indications for study as listed above as well as any other relevant history or symptomatology.
4 GENERAL CONSIDERATIONS Positioning of patient: The patient is generally examined in a supine position. In some patients, especially those with extreme abdominal girth, it may be necessary to turn the patient onto the left side and to use the liver as an acoustic window. To image the proximal aorta turn the patient onto the right side and use the kidney as an acoustic window to image the mid-aorta. Despite the large girth a good window can be obtained with the patient lying onto their left side. This is also an excellent view when imaging a tortuous aorta. Abdominal gas may also be a problem. Imaging from the side will often ovoid the stomach and duodenal gas. TEST PROTOCOL Evaluate the entire length of the abdominal aorta in the transverse plane. Begin at xiphoid process and scan distal to the bifurcation. NOTE: When scanning in the transverse plane, always keep the transducer perpendicular to the vessel. An oblique view will produce erroneous diameter measurements. When scanning the tortuous aorta be sure to remain in the true orthogonal 90 angle to the aorta.
5 Identify the renal arteries and take a measurement and picture at this level. Locate the renal arteries with colour. If there is turbulence take a Duplex recording. At this point turn the colour off and measure the aorta at this level. At the site of maximal dilatation, measure and record the maximum diameter. These measurements are taken from outer wall to outer wall, and if thrombus is present measure the residual lumen. Measure the aorta at the bifurcation. Evaluate entire length of the abdominal aorta in the longitudinal plane. The proximal aortic images should include the celiac axis and superior mesenteric artery, to ensure there is no supra renal artery aneurysm. Measure any dilatations in both AP and transverse.
6 In the longitudinal position locate the renal arteries and measure the distance from the renal artery to the aneurysm. In the longitudinal view turn the colour on, this will enable you to view either the right or left renal artery, you can then measure the length from the renal artery to the aneurysmal dilatation. Measure the longitudinal distal aorta measuring the cranial/caudal extent of the aneurysm. Document the distal neck from the distal extent of the aneurysm to the bifurcation. Document the shape of the aneurysm, characterizing it as either fusiform or as saccular, or dumbbell shaped Typical fusiform aneurysm Saccular aneurysms may be difficult to image particularly posterior protrusions (dotted line outlines saccular protrusion) Dumbbell or bi-lobed aneurysms are also quite common.
7 DUPLEX EXAMINATION Spectral tracing should be taken in the following locations, maintaining a 60 degree angle or less. Peak systolic velocity (PSV) should be recorded. Evaluate the supra renal segment and if a stenosis of the celiac axis or SMA is suspected these should be evaluated At the level of the renal arteries Mid aorta Distal aorta If an area of stenosis is noted, a PSV should be taken before the stenosis, thru the stenosis (being careful to evaluate the highest possible velocity), and post stenosis noting any post stenotic disturbance. If a colour bruit is seen at the renal artery origin examine take a Doppler trace at the origin and record the peak systolic velocity. In our practice we also routinely evaluate the renal artery origins and the initial examination. Normal spectral Doppler trace of the supra renal aorta. Spectral trace of the renal artery origins. Any stenotic areas should be noted and compared to the aortic velocity and a RAR (renal artery ratio) recorded. Note the increased velocities in the right renal artery, and normal velocities on the left. The aortic velocity at the level of the renal arteries was 107 cm/sec giving an RAR of 3.2 = <60% stenosis. Mid aortic waveforms may be bi or tri-phasic however within the aneurysm you usually notice a decrease in velocity with waveforms dampened usually bi-phasic and often turbulent.
8 The aortic walls should be carefully examined for signs of irregularity Colour Doppler is also of value when examining the internal lumen of the aneurysm as irregular thrombus and soft anechoic areas can be a sign of unstable plaque that may embolise distally. Irregular mixed thrombus which was embolising to the lower extremities. ILIAC ARTERY ANEURYSMS Although isolated iliac aneurysms are quite rare (<1%) iliac aneurysms associated with Aortic aneurysms are found in up to 20% of patients. The iliac arteries should be evaluated in both the transverse and longitudinal planes from the bifurcation to the inguinal ligaments. If an aneurysm is present measure the greatest diameter in both the transverse and longitudinal planes, the same as described in the aortic section. If possible measure the distance from either the bifurcation of the aorta or from the internal iliac artery. A spectral trace should be taken in the CIA, IIA, EIA. Any plaque or stenosis should be documented. Transverse image of a iliac aneurysm measuring the AP and transverse measurement as well as the residual lumen. Colour Doppler image of a CIA aneurysm with measurement from the aortic bifurcation to the proximal portion of the aneurysm. A normal spectral trace demonstrating the high resistant tri-phasic flow of the CIA.
9 REPORTIING If a patient is found to have an aneurysm greater than 6 cm at the maximum diameter measurement, or there is a concern that the aneurysm is unstable, the referring physician or his designee is contacted before the patient leaves the Laboratory. Data is assembled on appropriate worksheet and sent to a vascular surgeon for reporting. Detailed pathology, velocity information and measurements are documented onto a detailed worksheet allowing the referring doctor to quickly assess the information. Representative images are placed into the worksheet and all other images are kept on file electronically and available for or printing. An interim report is faxed to the referring physician the same day and a copy of the final report is sent to the referring physician. CLEANIING AND CARE OF EQUIIPMENT Acoustic gel is wiped from transducer, which is then cleaned with Transept disinfectant. Infectious disease policy is followed with all patients regardless of known infectious disease status.
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
More informationCarotid 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
More informationVisceral 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.
More informationIndications: 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
More informationAbdominal Aortic Aneurysms. A Surgeons Perspective Dr. Derek D. Muehrcke
Abdominal Aortic Aneurysms A Surgeons Perspective Dr. Derek D. Muehrcke Aneurysm Definition The abnormal enlargement or bulging of an artery caused by an injury or weakness in the blood vessel wall A localized
More informationCase 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
More informationAbdominal Ultrasonography
Abdominal Ultrasonography David A. Masneri, DO, FACEP, FAAEM Assistant Professor of Emergency Medicine Assistant Director, Emergency Medicine Residency Medical Director, Operational Medicine Division Center
More informationDuplex 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
More information1=presence Of Abdominal Aorta Aneurysm, 0=no Presence Of Abdominal Aorta Aneurysm
Derived Variable Dataset (AAA_DERV) ARIC V5 / NCS Code Book III, S.2 Page 1 of 9 Derived Variable Dataset: FORM CODE=AAA_DERV VERSION=1.0 Instructions: Derived variables for AAA study. AAA 1=presence Of
More informationDuplex ultrasound is first-line imaging for all
Our Protocol for Transabdominal Pelvic Vein Duplex Ultrasound A summary of s protocol for pelvic vein duplex ultrasonography, including equipment, patient positioning, ultrasound settings, and technique.
More informationTalent Abdominal Stent Graft
Talent Abdominal with THE Xcelerant Hydro Delivery System Expanding the Indications for EVAR Treat More Patients Short Necks The Talent Abdominal is the only FDA-approved device for proximal aortic neck
More information11 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
More informationGUNDERSEN/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
More informationGuidelines, Policies and Statements D5 Statement on Abdominal Scanning
Guidelines, Policies and Statements D5 Statement on Abdominal Scanning Disclaimer and Copyright The ASUM Standards of Practice Board have made every effort to ensure that this Guideline/Policy/Statement
More informationRecommendations 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
More informationWhat 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
More informationZenith Renu AAA Converter Graft. Device Description Planning and Sizing Deployment Sequence Patient Follow-Up
Zenith Renu AAA Converter Graft Device Description Planning and Sizing Deployment Sequence Patient Follow-Up Device description: Device indications The Zenith Renu AAA Converter Graft with Z-Trak Introduction
More informationAbdominal Aortic Aneurysm 가천대길병원 이상준
Abdominal Aortic Aneurysm 가천대길병원 이상준 1 Definition Diameter of the aorta 1.5 times greater than normal. Most are infrarenal, and a significant number extend down into one or both iliac arteries Abdominal
More informationPERPHERAL ARTERY ANEURYSM. By Pooja Sharma and Susanna Sebastianpillai
PERPHERAL ARTERY ANEURYSM By Pooja Sharma and Susanna Sebastianpillai Defintions True Aneurysm Involves all three layers of the vessel. Have two basic shapes; Fusiform = symmetric widening of the vessels
More informationWhat 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
More informationTransducer 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
More informationAn Overview of Post-EVAR Endoleaks: Imaging Findings and Management. Ravi Shergill BSc Sean A. Kennedy MD Mark O. Baerlocher MD FRCPC
An Overview of Post-EVAR Endoleaks: Imaging Findings and Management Ravi Shergill BSc Sean A. Kennedy MD Mark O. Baerlocher MD FRCPC Disclosure Slide Mark O. Baerlocher: Current: Consultant for Boston
More informationAbdominal and thoracic aneurysm repair
Abdominal and thoracic aneurysm repair William A. Gray MD Director, Endovascular Intervention Cardiovascular Research Foundation Columbia University Medical Center Abdominal Aortic Aneurysm Endografts
More informationScanning Mesenteric and Hypogastric Artery Aneurysms
Scanning Mesenteric and Hypogastric Artery Aneurysms Marsha M. Neumyer, BS, RVT, FSVU, FSDMS, FAIUM International Director Vascular Diagnostic Education Services Vascular Resource Associates Harrisburg,
More informationNo 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
More informationEndovascular Repair o Abdominal. Aortic Aneurysms. Cesar E. Mendoza, M.D. Jackson Memorial Hospital Miami, Florida
Endovascular Repair o Abdominal Aortic Aneurysms Cesar E. Mendoza, M.D. Jackson Memorial Hospital Miami, Florida Disclosure Nothing to disclose. 2 Mr. X AAA Mr. X. Is a 70 year old male who presented to
More informationVascular 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
More informationFeasibility of aortic neck anatomy for endovascular aneurysm repair in Korean patients with abdominal aortic aneurysm
LINC 2019 Leipzig, Germany Feasibility of aortic neck anatomy for endovascular aneurysm repair in Korean patients with abdominal aortic aneurysm Deokbi Hwang, Sujin Park, Hyung-Kee Kim, Seung Huh Division
More informationPolicies and Statements D16. Intracranial Cerebrovascular Ultrasound
Policies and Statements D16 Intracranial Cerebrovascular Ultrasound SECTION 1: INSTRUMENTATION Policies and Statements D16 Intracranial Cerebrovascular Ultrasound May 2006 (Reaffirmed July 2007) Essential
More informationCase 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
More informationMesenteric/Splanchnic Artery Duplex Imaging
VASCULAR TECHNOLOGY PROFESSIONAL PERFORMANCE GUIDELINES Mesenteric/Splanchnic Artery Duplex Imaging This Guideline was prepared by members of the Society for Vascular Ultrasound (SVU) as a template to
More informationCarotid Imaging IT S ABOUT MORE THAN JUST OBTAINING THE IMAGES
Carotid Imaging IT S ABOUT MORE THAN JUST OBTAINING THE IMAGES No financial or commercial relationships to disclose Carotid artery disease: Stroke is one of the most serious causes of mortality and morbidity
More informationRadRx Your Prescription for Accurate Coding & Reimbursement Copyright All Rights Reserved.
Interventional Radiology Coding Case Studies Prepared by Stacie L. Buck, RHIA, CCS-P, RCC, CIRCC, AAPC Fellow President & Senior Consultant Week of November 19, 2018 Abdominal Aortogram, Bilateral Runoff
More informationAbdominal Aortic Aneurysm. Ultrasound Logbook. Name
Abdominal Aortic Aneurysm Ultrasound Logbook ame Contents AAA Accreditation Requirements 15 Abdominal Aorta Report Records 3 Formative Assessments 1 Summative Assessment AAA Accreditation Abdominal Aortic
More informationAbdominal 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
More informationRobert F. Cuff, MD FACS SHMG Vascular Surgery
Robert F. Cuff, MD FACS SHMG Vascular Surgery Objectives To become familiar with the commercially available fenestrated EVAR graft Discuss techniques to increase success Review available data to determine
More informationAbdominal Aortic Aneurysm - Part 1. Learning Objectives. Disclosure. University of Toronto Division of Vascular Surgery
University of Toronto Division of Vascular Surgery Abdominal Aortic Aneurysm - Part 1 Dr Mark Wheatcroft & Dr Elisa Greco Vascular Surgeon, St Michael s Hospital, Toronto & University of Toronto Disclosure
More informationOpen fenestration for complicated acute aortic B dissection
Art of Operative Techniques Open fenestration for complicated acute aortic B dissection Santi Trimarchi 1, Sara Segreti 1, Viviana Grassi 1, Chiara Lomazzi 1, Marta Cova 1, Gabriele Piffaretti 2, Vincenzo
More informationBeyond 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
More informationNON-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
More informationDiseases of the aorta
Diseases of the aorta Aneurysm, dissection and aortitis are the main pathologies (Fig. 18.79 ). data:text/html;charset=utf-8,%3ch2%20id%3d%22cc5a0836d6aa490ca26dd7c15632b559%22%20style%3d%22margin%3a%201.3em%200px%200.5em%3b%20padding%3a%200px%3b%20border%3a%200px%3b%20font-fa
More informationCarotid 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
More informationMESENTERIC 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
More informationAn aneurysm is a localized abnormal dilation of a blood vessel or the heart Types: 1-"true" aneurysm it involves all three layers of the arterial
An aneurysm is a localized abnormal dilation of a blood vessel or the heart Types: 1-"true" aneurysm it involves all three layers of the arterial wall (intima, media, and adventitia) or the attenuated
More informationWhat 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
More informationGuide to Small Animal Vascular Imaging using the Vevo 770 Micro-Ultrasound System
Guide to Small Animal Vascular Imaging using the Vevo 770 Micro-Ultrasound System January 2007 Objectives: After completion of this module, the participant will be able to accomplish the following: Understand
More informationEndovascular options of treating iliac aneurysms
Endovascular options of treating iliac aneurysms Marek Majewski Department of Vascular Surgery of P. Desgranges Henri Mondor Hospital University Paris XII Créteil, France Common Iliac Artery Aneurysms
More informationAccess More Patients. Customize Each Seal.
Access More. Customize Each Seal. The Least Invasive Path Towards Proven Patency ULTRA LOW PROFILE TO EASE ADVANCEMENT The flexible, ultra-low 12F ID Ovation ix delivery system enables you to navigate
More informationPhysician s Vascular Interpretation Examination Content Outline
Physician s Vascular Interpretation Examination Content Outline (Outline Summary) # Domain Subdomain Percentage 1 2 3 4 5 6 Cerebrovascular Abdominal Peripheral Arterial - Duplex Imaging Peripheral Arterial
More informationChallenges. 1. Sizing. 2. Proximal landing zone 3. Distal landing zone 4. Access vessels 5. Spinal cord ischemia 6. Endoleak
Disclosure I have the following potential conflicts of interest to report: Consulting: Medtronic, Gore Employment in industry Stockholder of a healthcare company Owner of a healthcare company Other(s)
More informationVisceral aneurysm. Diagnosis and Interventions M.NEDEVSKA
Visceral aneurysm Diagnosis and Interventions M.NEDEVSKA History 1953 De Bakeyand Cooley Visceral aneurysm VAAs rare, reported incidence of 0.01 to 0.2% on routine autopsies. Clinically important Potentially
More informationImportant Update to Field Safety Notice Nellix EndoVascular Aneurysm Sealing System Updated Instructions for Use (IFU)
October 6, 2017 Important Update to Field Safety Notice Nellix EndoVascular Aneurysm Sealing System Updated Instructions for Use (IFU) Dear Physician, This notification is to provide you with further information
More informationNon-invasive examination
Non-invasive examination Segmental pressure and Ankle-Brachial Index (ABI) The segmental blood pressure (SBP) examination is a simple, noninvasive method for diagnosing and localizing arterial disease.
More informationCertificate in Clinician Performed Ultrasound (CCPU) Syllabus
Certificate in Clinician Performed Ultrasound (CCPU) Syllabus Abdominal Aortic Aneurysm (AAA) Page 1 of 6 12/18 Abdominal Aortic Aneurysm (AAA) Syllabus Purpose: This unit is designed to cover the theoretical
More informationBackground & Indications Probe Selection
Teresa S. Wu, MD, FACEP Director, EM Ultrasound Program & Fellowship Co-Director, Simulation Based Training Program & Fellowship Associate Program Director, EM Residency Program Maricopa Medical Center
More informationThe role of ultrasound duplex in endovenous procedures
The role of ultrasound duplex in endovenous procedures Neophytos A. Zambas MD, PhD Vascular Surgeon Polyclinic Ygia, Limassol, Cyprus ΚΕΑΕΧ ΚΥΠΡΙΑΚΗ ΕΤΑΙΡΕΙΑ ΑΓΓΕΙΑΚΗΣ ΚΑΙ ΕΝΔΑΓΓΕΙΑΚΗΣ ΧΕΙΡΟΥΡΓΙΚΗΣ Pre
More informationDISCLOSURE 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
More informationBifurcated system Proximal suprarenal stent Modular (aortic main body and two iliac legs) Full thickness woven polyester graft material Fully
Physician Training Bifurcated system Proximal suprarenal stent Modular (aortic main body and two iliac legs) Full thickness woven polyester graft material Fully supported by self-expanding z-stents H&L-B
More informationPAH EMERGENCY Department Aortic Scanning module
PAH EMERGENCY Department Aortic Scanning module Abdominal Aorta Scan is a goal directed ultrasound examination to detect the presence of an Abdominal Aortic Aneurysm (AAA). The Abdominal Aorta scan is
More informationCertificate in Clinician Performed Ultrasound (CCPU) Syllabus. Abdominal Aortic Aneurysm (AAA)
Certificate in Clinician Performed Ultrasound (CCPU) Syllabus Abdominal Aortic Aneurysm (AAA) Purpose: Prerequisites: Training: Assessments: Course Objectives Abdominal Aortic Aneurysm (AAA) This unit
More informationAcute Aortic Syndromes
Acute Aortic Syndromes Carole J. Dennie, MD Acute Thoracic Aortic Syndromes Background Non-Traumatic Acute Thoracic Aortic Syndromes Carole Dennie MD FRCPC Associate Professor of Radiology and Cardiology
More informationCase 37 Clinical Presentation
Case 37 73 Clinical Presentation The patient is a 62-year-old woman with gastrointestinal (GI) bleeding. 74 RadCases Interventional Radiology Imaging Findings () Image from a selective digital subtraction
More informationAbdominal 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
More informationCase 9799 Stanford type A aortic dissection: US and CT findings
Case 9799 Stanford type A aortic dissection: US and CT findings Accogli S, Aringhieri G, Scalise P, Angelini G, Pancrazi F, Bemi P, Bartolozzi C Department of Diagnostic and Interventional Radiology, University
More informationManagement of the persistent sciatic artery with coexistent aortoiliac aneurysms; endovascular and open techniques.
ISPUB.COM The Internet Journal of Thoracic and Cardiovascular Surgery Volume 14 Number 2 Management of the persistent sciatic artery with coexistent aortoiliac aneurysms; endovascular and open A Rodriguez-Rivera,
More informationThe 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
More informationHistory of the Powerlink System Design and Clinical Results. Edward B. Diethrich Arizona Heart Hospital Phoenix, AZ
History of the Powerlink System Design and Clinical Results Edward B. Diethrich Arizona Heart Hospital Phoenix, AZ Powerlink System: Unibody-Bifurcated Design Long Main Body Low-Porosity Proprietary eptfe
More informationSchedule of Benefits. for Professional Fees Vascular Procedures
Schedule of Benefits for Professional Fees 2018 Vascular Procedures ANASTOMOSIS RULES 820 Arteriovenous anastomosis in arm 1453 Arteriovenous anastomosis, open by basilic vein transposition 1465 Splenorenal
More informationCarotid 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
More informationA New EVAR Device for Infrarenal AAAs
A New EVAR Device for Infrarenal AAAs Peter Nelson, MD, MS Assistant Professor of Surgery MM0203 Rev. 01 Current U.S. EVAR Devices Anatomical Fixation Proximal Fixation Powerlink - Endologix Excluder WL
More informationRadRx Your Prescription for Accurate Coding & Reimbursement Copyright All Rights Reserved.
Interventional Radiology Coding Case Studies Prepared by Stacie L. Buck, RHIA, CCS-P, RCC, CIRCC, AAPC Fellow President & Senior Consultant INDICATION: Abdominal aortic aneurysm. INTERVENTIONAL RADIOLOGIST:
More informationRENAL 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
More informationAbdominal Vascular Arterial Disease
Abdominal Vascular Arterial Disease Abdominal Vascular Arterial Disease People take better care of their health when they know what s going on in their bodies. For those with abdominal vascular arterial
More informationUltrasound 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
More informationEvaluation of Dynamic Intimal Flap Movement in Acute Stanford Type B Aortic Dissections (ATBD) and the Effects of Thoracic Endovascular Stent Grafting
Evaluation of Dynamic Intimal Flap Movement in Acute Stanford Type B Aortic Dissections (ATBD) and the Effects of Thoracic Endovascular Stent Grafting Frank R. Arko, III, MD, Jeko Madjarov, MD, Aaron Hurd,
More informationMODERN METHODS FOR TREATING ABDOMINAL ANEURYSMS AND THORACIC AORTIC DISEASE
MODERN METHODS FOR TREATING ABDOMINAL ANEURYSMS AND THORACIC AORTIC DISEASE AAA FACTS 200,000 New Cases Each Year Ruptured AAA = 15,000 Deaths per Year in U.S. 13th Leading Cause of Death 80% Chance of
More information1. 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.
More informationMid-term results of 300+ patients treated by endovascular aortic sealing (EVAS)
Mid-term results of 300+ patients treated by endovascular aortic sealing (EVAS) Jean-Paul P.M. de Vries Dept Vascular Surgery St. Antonius Hospital, Nieuwegein,The Netherlands On behalf of the DEVASS study
More informationRadial Artery Assessment for Coronary Artery Bypass
VASCULAR TECHNOLOGY PROFESSIONAL PERFORMANCE GUIDELINES Radial Artery Assessment for Coronary Artery Bypass This Guideline was prepared by the Professional Guidelines Subcommittee of the Society for Vascular
More informationVascular 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,
More informationSection 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
More informationHD 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
More informationAORTIC ANEURYSM. howmed.net
AORTIC ANEURYSM howmed.net ANATOMY It is important to understand the anatomy of the aorta Need to know the extent of the aneurysm Need to know the vessels involved This helps with Medical or Surgical management
More informationLikes ML, Johnston TA. Gastric pseudoaneurysm in the setting of Loey s Dietz Syndrome. Images Paediatr Cardiol. 2012;14(3):1-5
IMAGES in PAEDIATRIC CARDIOLOGY Likes ML, Johnston TA. Gastric pseudoaneurysm in the setting of Loey s Dietz Syndrome. Images Paediatr Cardiol. 2012;14(3):1-5 University of Washington, Pediatrics, Seattle
More informationVascular CT Protocols
Vascular CT Protocols V 1D: Chest and abdominal CT angiogram (aortic dissection protocol) V 1T: Chest CT angiogram (aortic trauma protocol) V 2: Abdominal and pelvis CT angiogram (aortic aneurysm protocol)
More informationFree Esophageal Perforation Following Hybrid Visceral Debranching and Distal Endograft Extension to Repair a Ruptured Thoracoabdominal Aortic
Free Esophageal Perforation Following Hybrid Visceral Debranching and Distal Endograft Extension to Repair a Ruptured Thoracoabdominal Aortic Aneurysm History A 56-year-old gentleman, who had been referred
More informationOptimizing Accuracy of Aortic Stent Grafts in Short Necks
Optimizing Accuracy of Aortic Stent Grafts in Short Necks Venkatesh Ramaiah, MD, FACS Medical Director Arizona Heart Hospital Director Peripheral Vascular and Endovascular Research Arizona Heart Institute
More informationΧρόνιος διαχωρισμός. υπερηχοκαρδιογραφική. αορτής. παρακολούθηση ή άλλη; Α. Παπασπυρόπουλος ΕΠΙΜΕΛΗΤΗΣ ΓΝ.ΝΙΚΑΙΑΣ ΠΕΜΠΤΗ
Χρόνιος διαχωρισμός αορτής υπερηχοκαρδιογραφική παρακολούθηση ή άλλη; Α. Παπασπυρόπουλος ΕΠΙΜΕΛΗΤΗΣ ΓΝ.ΝΙΚΑΙΑΣ ΠΕΜΠΤΗ 8-2-2018 The Normal Aorta (conduit function + control ) *Aortic expansion is about
More informationEducational Exhibit Authors:
Endoleaks in Abdominal Aortic Aneurysm Endoprosthesis: What radiologists need to know about Diagnostic, Characterization and Basic Management Strategies Poster No.: C-0150 Congress: ECR 2013 Type: Educational
More informationAcute Type B dissection. Closure of the infra diaphragmatic tear: how and when?
Acute Type B dissection. Closure of the infra diaphragmatic tear: how and when? Prof. Olgierd Rowiński II Department of Clinical Radiology Medical University of Warsaw Disclosure Speaker name: Olgierd
More informationIntravascular Ultrasound in the Treatment of Complex Aortic Pathologies. Naixin Kang, M.D. Vascular Surgery Fellow April 26 th, 2018
Intravascular Ultrasound in the Treatment of Complex Aortic Pathologies Naixin Kang, M.D. Vascular Surgery Fellow April 26 th, 2018 DISCLOSURES Nothing To Disclose 2 ENDOVASCULAR AORTIC INTERVENTION Improved
More informationINL No. A0083 Project Medtronic Thoracic patients guide Description Version 18
INL No. A0083 Project Medtronic Thoracic patients guide Description Version 18 www.inl-agency.com PATIENT INFORMATION BOOKLET Endovascular Stent Grafts: A treatment for Thoracic Aortic disease Table of
More informationMy personal experience with INCRAFT in standard and challenging cases
My personal experience with INCRAFT in standard and challenging cases G Pratesi, MD Vascular Surgery University of Rome Tor Vergata giovanni.pratesi@uniroma2.it Disclosure Speaker name: Giovanni Pratesi,
More informationCurrent treatment of Aortic Aneurysms and Dissections. Adam Keefer, MD, FACS Sean Hislop, MD, FACS
Current treatment of Aortic Aneurysms and Dissections Adam Keefer, MD, FACS Sean Hislop, MD, FACS Patient 1 69 year old well-educated man with reoccurring pain in his upper abdomen and a pulsatile mass.
More informationChungbuk Regional Cardiovascular Center, Division of Cardiology, Departments of Internal Medicine, Chungbuk National University Hospital Sangmin Kim
Endovascular Procedures for Isolated Common Iliac and Internal Iliac Aneurysm Chungbuk Regional Cardiovascular Center, Division of Cardiology, Departments of Internal Medicine, Chungbuk National University
More informationIs EVAS a proper choice in women?
Is EVAS a proper choice in women? CACVS 2018 Jan MM Heyligers, PhD, FEBVS Consultant Vascular Surgeon Elisabeth TweeSteden Hospital Tilburg The Netherlands Disclosures Consultant for Endologix DEVASS =Dutch
More informationFEVAR FIFTEEN YEARS OF EFFICIENCY E.DUCASSE MD PHD FEBVS CHU DE BORDEAUX
FEVAR FIFTEEN YEARS OF EFFICIENCY E.DUCASSE MD PHD FEBVS CHU DE BORDEAUX 2018 A BIT OF HISTORY First use of F-EVAR : 1990s Park et al. J Vasc Interv Radiol. 1996;7:819-823. Faruqi et al. J Endovasc Surg.
More informationGuidelines, Policies and Statements D20 Statement on Peripheral Venous Ultrasound
Guidelines, Policies and Statements D20 Statement on Peripheral Venous Ultrasound Disclaimer and Copyright The ASUM Standards of Practice Board have made every effort to ensure that this Guideline/Policy/Statement
More informationDiseases of the Aorta
Diseases of the Aorta ASE Review 2018 Susan E Wiegers, MD, FASE, FACC Professor of Medicine My great friend Dr. Roberto Lang Disclosure None related to this presentation 1 Objectives Aneurysm Dissection
More informationAsymptomatic Radiology / Clinical data Report / Cohort bias Referral bias. UCSF Vascular Symposium April 7-9, Acute Aortic Dissection
Aortic Dissection: Natural History What is the Natural History of Aortic Dissection? UCSF Vascular Symposium April 7-9, 2011 Asymptomatic Radiology / Clinical data Report / Cohort bias Referral bias Stephen
More information