This expert consensus statement on the interpretation of peripheral arterial and venous spectral Doppler waveforms was jointly commissioned by the Society for Vascular Medicine (SVM) and the Society for Vascular Ultrasound (SVU). The consensus statement proposes a standardized nomenclature for arterial and venous spectral Doppler waveforms using a framework of key major descriptors and additional modifier terms. These key major descriptors and additional modifier terms are presented alongside representative Doppler waveforms, and nomenclature tables provide context by listing previous alternate terms to be replaced by the new major descriptors and modifiers. Finally, the document reviews Doppler waveform alterations with physiologic changes and disease states, provides optimization techniques for waveform acquisition and display, and provides practical guidance for incorporating the proposed nomenclature into the final interpretation report.

On the basis of the USI data alone, a prediction of arteriographic findings was possible at the 95% level for occlusion and severe stenosis and for ruling out hemodynamically significant stenosis. The addition of velocity data improved prediction in borderline degrees of stenosis. USI was effective for quantifying clinically significant degrees of stenosis.

185Doppler instruments are widely used for the noninvasive evaluation of peripheral arterial disease. Auditory descriptors and graphic displays of waveforms characterize the hemodynamics of the vessel being examined. Descriptions of normal Characterization of peripheral arterial waveforms is basic to the diagnosis of vascular disease. Surveys indicate inconsistent application of traditional waveform descriptors. This study reviews literature to identify areas of confusion. Publications were reviewed to determine whether triphasic, biphasic, and monophasic terms were defined; if biphasic was linked with diastolic flow reversal; whether pandiastolic flow was associated with biphasic or monophasic terminology; and whether waveform illustrations had a zero baseline. Ninety-four publications were reviewed. Triphasic and monophasic were defined in 81%, biphasic in 48%. Biphasic was classified with flow reversal in 38%. Pandiastolic flow was not addressed in 57% but associated with monophasic in 47% and biphasic in 5%. Twenty-one percent of the publications had an illustration without a zeroflow baseline. This review suggests a lack of consensus when classifying arterial blood flow with traditional waveform descriptors. Waveform characterization inconsistencies are undermining comprehension of Doppler principles and may lead to inappropriate testing. A multisocietal consensus panel should accept responsibility for resolving this issue.

Doppler waveform analysis is a fundamental part of evaluating peripheral arterial disease. Waveform characteristics are traditionally defined as multiphasic (triphasic, biphasic) and monophasic. The purpose of this investigation is to evaluate whether sonography professionals correctly classify waveforms into these three categories. Thirty Doppler waveforms (15 continuous-wave [CW] and 15 pulsed-wave [PW] Doppler) were obtained from patients with previous noninvasive peripheral arterial evaluations. Participating readers were asked to interpret waveforms as triphasic, biphasic, or monophasic using standard definitions. “Other” was used to classify waveforms whose morphology could not be determined or accurately classified as triphasic, biphasic, or monophasic. Because multiphasic waveforms with pandiastolic flow have been associated with biphasic and monophasic waveform terminology, answer key responses were based on waveform descriptors used by interpreters of the originating noninvasive evaluation. There were a total of 97 participants, and of all Doppler waveforms, 73% were correctly identified (75% CW and 71% PW). Participants training or specializing in medical sonography misidentified an average of 27% triphasic, biphasic, or monophasic CW and PW Doppler waveforms and correctly interpreted more CW than PW waveforms. Because there is considerable variability among sonography professionals and educators in defining and classifying peripheral arterial waveforms, this issue deserves higher priority.

This expert consensus statement on the interpretation of peripheral arterial and venous spectral Doppler waveforms was jointly commissioned by the Society for Vascular Medicine (SVM) and the Society for Vascular Ultrasound (SVU). The consensus statement proposes a standardized nomenclature for arterial and venous spectral Doppler waveforms using a framework of key major descriptors and additional modifier terms. These key major descriptors and additional modifier terms are presented alongside representative Doppler waveforms, and nomenclature tables provide context by listing previous alternate terms to be replaced by the new major descriptors and modifiers. Finally, the document reviews Doppler waveform alterations with physiologic changes and disease states, provides optimization techniques for waveform acquisition and display, and provides practical guidance for incorporating the proposed nomenclature into the final interpretation report.