Ultrasonography in Vascular Diagnosis

Abstract

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Sonographic grading of recurrent stenosis after carotid stenting and stented peripheral arteries

“…The relevance of and need for studies on grading according to the continuity law (prestenotic cross-sectional vessel area/intrastenotic area = intrastenotic PSV/prestenotic PSV) can be called into question, since physical laws that were confirmed in in vitro experiments form the basis of stenosis grading. This ratio (intrastenotic PSV/prestenotic PSV) corresponds closely, from low-grade up to 90% stenosis, in terms of stenosis grade with the values determined by the continuity law, where the degree of stenosis = (1-1/PSV ratio) × 100 [25].…”

“…Table 1). These predominantly Anglo-American studies carried out exclusively according to the degree of distal stenosis (the North American Symptomatic Carotid Endarterectomy Trial, NASCET, criterion) from 2002 to 2008, led to additional misunderstandings in German-speaking countries in the comparison of threshold velocities in native carotid stenosis, since the threshold velocities of these study results for recurrent stenosis were compared with the degree of local stenosis (European Carotid Surgery Trial, ECST, criterion) used at that time in the German-speaking regions for de novo stenosis [25]. When converted, this grade of local stenosis shows approximately 30% higher PSV values for 50-70% stenosis compared to the degree of distal stenosis (NASCET criterion).…”

“…The PSV in this group was 230-455 cm/s. A total of 18 patients with a ratio of 2-4 had a PSV of 125-280 cm/s [25] in 50-75% stenosis. Here, however, the ratio and not the absolute PSV forms the basis for stenosis grading.…”

“…Table 1) should also be taken into account for equivocal or unclear findings. Furthermore, the secondary criteria known from the diagnosis of native ICA stenosis should also be taken into consideration [25,27].…”

Ultrasonographic features of vascular closure devices: initial and 6-month follow-up results

“…After 6 months, the lesion regarded as the bioabsorbable materials had partially disappeared (8/8), while some of them (3/8) coexisted with hypoechoic thickening of the arterial intima. In the previous article [6], intimal hyperplasia occurred after vessel injury, which was manifested as the hypoechoic thickening of the arterial intima. Intimal hyperplasia is a physiologic response to injury to the blood vessel wall and results from vascular surgery and endovascular intervention.…”