vascular casesjbcvascularsummit.com/wp-content/uploads/2018/04/... · 2018. 4. 24. · clinical...
TRANSCRIPT
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Vascular Cases
Ann Marie Kupinski, PhD RVT RDMS FSVUNorth Country Vascular Diagnostics, Inc,
& Albany Medical College, Albany, NY
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Clinical Presentation
• 67 year old male• Brachial artery to basilic vein transposition fistula• Difficulty with dialysis with increased venous
pressures
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What do you think so far?
• Is the inflow waveform normal?• Is the anastomotic velocity normal?• Is the fistula PSV normal?• Is the fistula flow normal?
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Venous Stenosis• Sonolucent
intraluminal material
• Luminal reduction by color flow
• Common at vein bifurcations & valves
• Can result from scarring of puncture sites
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Clinical Presentation
• 84 y.o. female • Vertigo • 30 mmHg brachial systolic pressure gradient• Prior CABG
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The left CCA
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Right CCA and ICA
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What is your diagnosis?
A. Distal ICA occlusion
B. Proximal ICA stenosis
C. Innominate artery stenosis/occlusion
D. Right subclavian artery stenosis
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The answer is…Innominate artery stenosis/occlusion
Dampened distal innominate waveform
Retrograde right vertebral artery waveform
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Clinical Presentation
• 51 year old female• Brachial artery to basilic vein transposition fistula• Increased pressures on dialysis
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Clinical Presentation
• 75 year old white male • Bilateral carotid bruits• Right arm weakness• Speech difficulty
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What is your diagnosis?
A. Congenital atresia L ICAB. Stenosis/occlusion intracranial L ICAC. String sign L ICAD. Occlusion cervical LICA
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The answer is…
A. Congenital atresia L ICAB. Stenosis/occlusion intracranial L ICAC. String sign L ICAD. Occlusion cervical LICA