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