Unilateral CarotidVertebral Duplex Study - PowerPoint PPT Presentation

Title: Unilateral CarotidVertebral Duplex Study


1
Unilateral Carotid/Vertebral Duplex Study

• Montgomery College
• DMS 2004

2
Normal Anatomy
3
Normal Anatomy
4
Carotid duplex normal protocol

• Scan from the origin of the CCA to the most
  distal aspect in transverse and longitudinal
• Scan the ICA and ECA from their origin at the
  carotid bifurcation and follow each vessel as
  superiorly as possible
• Scan vertebral arteries from their origin to
  their most distal aspect
• After documenting normal anatomy with gray scale,
  apply color and pulsed wave Doppler on images to
  demonstrate blood flow dynamics

5
Scanning tips and techniques

• Use a 7.5 to 10 MHz transducer
• Have a patient lay flat on his/her back
• Place a pillow behind the patients shoulders (or
  no pillow) and turn the patients head to the
  side opposite the one you are scanning
• Hold transducer at the base so you can use your
  fingers as a guide on the patients neck
• Note most disease occurs at the carotid
  bifurcation

6
Sag Lt Common Carotid Artery
Prox - Mid
7
Sag Lt Common Carotid Artery
Distal
8
Sagittal Lt Bifurcation
ECA/ICA
9
ECA vs. ICA
ECA extracranial branches high- resistance
waveform temporal taps ICA no extracranial
branches low-resistance waveform
10
Bulb/ICA/ECA with STA branch
11
Lt CCA Bifurcation / ECA
with STA Branch
12
CCA BifurcationECA / ICA
13
Sag Lt Internal Carotid Artery
Posterior Projection
14
Sag Lt Internal Carotid Artery
Anterior Projection
15
Sagittal Lt Vertebral Artery
16
Sagittal Lt Vertebral Artery
17
Sagittal Lt Vertebral Artery
18
Sagittal Lt Vertebral Artery
19
Transverse Lt CCA Proximal
20
Transverse Lt CCA Mid
21
Transverse Lt CCA Dist
22
Transverse Lt CCA Bulb
23
Transverse Lt ICA / ECA
Prox
24
Transverse Lt ICA / ECA
Mid
25
Transverse Lt ICA / ECA
Distal
26
Pulsed-Wave Doppler Lt
CCA Prox
27
Pulsed-Wave Doppler Lt
CCA Mid
28
Pulsed-Wave Doppler Lt
CCA Dist
29
Pulsed-Wave Doppler
Lt ECA
30
Pulsed-Wave Doppler
Lt ECA
31
Pulsed-Wave Doppler
Lt ICA Origin
32
Pulsed-Wave Doppler Lt
ICA Prox
33
Pulsed-Wave Doppler
Lt ICA Mid
34
Pulsed-Wave Doppler
Lt ICA Dist
35
Pulsed-Wave Doppler Lt
Vertebral Artery