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Duplex Ultrasonography (duplex + ultrasonography)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Incidental Detection of Inferior Vena Caval Dissection by Intraoperative High Frequency Vascular Duplex Ultrasonography

ECHOCARDIOGRAPHY, Issue 3 2007
Sarinya Puwanant M.D.
Inferior vena caval (IVC) dissection has been rarely reported. This could be due to less susceptibility of the venous structure to dissect or under recognition of this entity. We first report a case of IVC dissection detected by high frequency surface ultrasonography following tumor thrombectomy of adrenal cortical carcinoma. This report described the value of intraoperative surface echocardiography and reviewed previous literatures with regard to IVC dissection. [source]

Portable duplex ultrasonography: A diagnostic and decision-making tool in reconstructive microsurgery

MICROSURGERY, Issue 5 2010
Andreas Gravvanis M.D., FEBOPRAS, Ph.D.
Unidirectional Doppler is a common diagnostic tool by the Reconstructive Microsurgeons; however, it may generate false signals and surely provides less imaging data as compared to duplex ultrasonography. We have reviewed the use of Portable Duplex Ultrasonography (PDU) in 16 patients who underwent complex soft-tissue/bone reconstruction, aiming to determine its role in the design and management of free tissue transfer. According to our data, there were modifications either of the surgical plan and/or of patient's management, based on PDU findings, in 10 out of 16 patients (62.5%). The use of ultrasound directed to subtle modifications in three patients (19%), but to significant changes of the surgical plan in four patients (25%). Also, the use of ultrasound improved significantly the postoperative management in three patients (19%). Thus, significant impact of PDU in patient's treatment was recorded in 44% of cases. Portable ultrasound represents generally available method for preoperative, intraoperative, and postoperative diagnosis and decision-making in free tissue transfer, hence could replace in the near future the unidirectional Doppler in the hands of Microsurgeons. © 2010 Wiley-Liss, Inc. Microsurgery 30:348,353, 2010. [source]

Duplex ultrasonography and varicose veins

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 5 2007
N. J. M. London
Duplex scans for all [source]

Ophthalmic Artery Flow Direction on Color Flow Duplex Imaging Is Highly Specific for Severe Carotid Stenosis

JOURNAL OF NEUROIMAGING, Issue 1 2002
Patrick S. Reynolds MD
Background/Purpose. Collateral flow patterns are important risk factors for brain ischemia in the presence of internal carotid artery (ICA) stenosis or occlusion. Ophthalmic artery (OA) flow reversal, routinely studied by transcranial Doppler sonography, is an important marker for high-grade ICA stenosis or occlusion. The authors sought to define the value of assessing OA flow direction with color flow duplex ultrasonography (CDUS) in the setting of significant ICA disease. Methods. Of all patients having routine carotid ultrasound in the neurosonology laboratory between July 1995 and November 2000, 152 had both carotid and orbital (OA flow direction by reduced power orbital CDUS) examinations as well as angiographic confirmation of stenosis to which North American Symptomatic Carotid Endarterectomy Trial criteria could be applied. Degree of angiographic stenosis in these 152 patients (304 arteries) was correlated with OA flow direction. Results. Of 304 arteries, 101 had greater than 80% stenosis by angiogram. In 56 of these 101 arteries with high-grade stenosis or occlusion, the ipsilateral OA was reversed; however, OA flow direction was never reversed ipsilateral to arteries with less than 80% stenosis (sensitivity 55%, specificity 100%, negative predictive value 82%, and positive predictive value 100% for OA flow reversal as a marker of high-grade carotid lesions). Discussion/Conclusions. OA flow direction is easily studied with CDUS. Reversed OA flow direction is highly specific (100%) for severe ipsilateral ICA stenosis or occlusion, with excellent positive predictive value, moderate negative predictive value, and limited sensitivity. OA flow reversal is not only quite specific for severe ICA disease, which may be helpful if the carotid CDUS is difficult or inadequate, but may also provide additional hemodynamic insights (ie, the inadequacy of other collateral channels such as the anterior communicating artery). OA evaluation can provide important hemodynamic information and should be included as part of carotid CDUS if there is any evidence of ICA stenosis or occlusion. [source]

Portable duplex ultrasonography: A diagnostic and decision-making tool in reconstructive microsurgery

Low antroduodenal pressure gradients are responsible for gastric emptying of a low-caloric liquid meal in humans

NEUROGASTROENTEROLOGY & MOTILITY, Issue 1 2002
T. HAUSKEN
The motor mechanisms responsible for transpyloric flow of gastric contents are still poorly understood. The aim of our study was to investigate the relationship between luminal pressures and gastric wall motion and between gastroduodenal pressure gradients and pressure waves, and ante- and retro-grade transpyloric flow. In eight healthy volunteers, intraluminal pressures were recorded from the antrum and proximal duodenum. Transpyloric flow was monitored simultaneously using duplex ultrasonography, before, during and after ingestion of 300 mL meat soup. Transpyloric emptying occurred as sequences of alternating periods of emptying,reflux,emptying. Approximately one-third of the sequences were not associated with peristalsis. The antroduodenal pressure gradients were significantly lower during nonperistaltic-related emptying than during peristaltic-related emptying (0.15 (0,0.3) kPa, and 1.7 (0.2,2.0) kPa, respectively [mean ± (range)], P < 0.005). The duration of emptying episodes not associated with peristalsis were significantly longer than those associated with peristalsis at (6.5 (3,8.7) s and 4.4 (2,6) s, respectively, P=0.059). Manometry detected only 56% of the antral contractions seen on ultrasound. We concluded that gastric emptying of a low-calorie liquid meal occurs both during peristaltic and nonperistaltic antral activity. In spite of lower antroduodenal pressure gradients, the emptying episodes were longer for nonperistaltic emptying, which is likely to be caused by low pyloric resistance. Considerable flow seems to occur without peristalsis during gastric emptying of a low-calorie, liquid meal in humans. [source]

Bilateral testicular tuberculomas: a case detection

ANDROLOGIA, Issue 2 2009
A. Hassan
Summary Genitourinary tuberculosis (TB) is the most frequent manifestation of extrapulmonary TB, where the epididymides, seminal vesicles and prostate are the commonly infected sites, followed by the testes. We report a 29-year-old man who presented with primary infertility since 2 years. He had a history of bilateral painful scrotal swelling with fever since 4 years, diagnosed as pyogenic scrotal abscess, which was managed by incision and drainage. At presentation, fever, weight loss and night sweats were absent. On examination, he had ovoid slightly tender, firm to hard irregular masses in the lower poles of both testes with no line of separation encroaching on both epididymes. Both testes were not felt distinctly and the overlying scrotal skin showed no signs of inflammation. Semen analysis revealed azoospermia. Scrotal colour coded duplex ultrasonography demonstrated moderately enlarged testes having well defined hypoechoic masses with foci of calcifications. Magnetic resonance imaging confirmed these findings. Biopsy and histopathology detected the presence of caseating granuloma and Ziehl,Neelsen staining of paraffin sections demonstrated acid-fast bacilli. The patient was treated with combination therapy. Tracing of the condition is discussed. [source]

A double-blind placebo-controlled study of the efficacy and safety of pentoxifylline in early chronic Peyronie's disease

BJU INTERNATIONAL, Issue 2 2010
Mohammad Reza Safarinejad
Study Type , Therapy (RCT) Level of Evidence 1b OBJECTIVE To analyse the safety and efficacy of pentoxifylline sustained-release (PTX-SR) treatment in patients with early chronic Peyronie's disease (PD). PATIENTS AND METHODS In all, 228 patients with a mean (sd) age of 51 (9) years who had early chronic PD were randomized to receive 400 mg PTX-SR (Apo-Pentoxifylline, Apotex Inc., Toronto, Canada) twice daily (group 1, 114) or similar regimen of placebo (group 2, 114) for 6 months. A medical history was taken and the men had a complete physical examination. The following variables were assessed before and after therapy: penile curvature and penile artery spectral traces (end-diastolic velocity, EDV, peak systolic velocity, PSV, and resistivity index, RI, of the right and left cavernous arteries assessed with dynamic penile duplex ultrasonography), plaque characteristics (assessed by penile X-ray and penile ultrasonography), pain (assessed by visual analogue scale), erectile function (assessed by the International Index of Erectile Function, IIEF questionnaire), treatment satisfaction (assessed by Erectile Dysfunction Inventory of Treatment Satisfaction questionnaire), and side-effects. Patient perception of penile curvature and plaque size, and mean weekly intercourse attempts were also assessed. RESULTS Overall, 36.9% of patients who received PTX-SR reported a positive response, vs only 4.5% in the placebo group. Of patients in PTX-SR group, 12 (11%) had disease progression, vs 46 (42%) in placebo group (P = 0.01). Improvement in penile curvature (P = 0.01), and plaque volume (P = 0.001) was significantly greater in patients treated with PTX-SR than placebo. The increase in IIEF total score was significantly higher in the PTX-SR group (P = 0.02). Mean PSV changes after therapy compared to baseline were statistically significant between PTX-SR (right, +11.4%, left, +11.7%) and placebo-treated (+0.2% and ,4.2%, respectively) patients (both P = 0.04). CONCLUSIONS PTX-R was moderately effective in reducing penile curvature and plaque volume in patients with early chronic PD. Further studies with different treatment regimens are needed to better elucidate the beneficial effects of PTX-SR in PD. [source]

The use of a fixed high sensitivity to evaluate five D -dimer assays' ability to rule out deep venous thrombosis: a novel approach

BRITISH JOURNAL OF HAEMATOLOGY, Issue 3 2005
Scott M. Stevens
Summary Suspected deep venous thrombosis (DVT) is difficult to refute without complex diagnostic algorithms and expensive testing. We analysed five d -dimer assays' utility for exclusion of suspected DVT during a prospective clinical cohort trial, choosing a highly sensitive cut-off value at which to compare the assays. Assays were performed on 436 consecutive patients who were referred with symptoms that suggested a first episode of DVT. Venous thromboembolism (VTE) was defined as positive findings on comprehensive duplex ultrasonography or any episode, or complication of VTE detected during 3 months of clinical follow-up. All five assays were performed in 377 patients. At a highly sensitive cut-off value, all five assays reliably excluded DVT in the study population. While the choice of a highly sensitive cut-off value reduced the specificity of all the assays, the change in specificity differed between tests. Our findings suggest that a second-generation d -dimer assay could be used as a stand-alone test to rule out suspected DVT when a highly sensitive cut-off value is chosen. These findings should be subjected to a prospective management study, as a small reduction in sensitivity from our findings could result in a clinically relevant decrease in negative predictive value. [source]

Incidence of deep vein thrombosis after varicose vein surgery

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 12 2004
A. M. van Rij
Background: Varicose vein surgery is generally considered to have little risk of postoperative deep vein thrombosis (DVT). This prospective study examined the incidence of DVT in patients undergoing varicose vein surgery. Methods: Lower leg veins were assessed before operation by duplex ultrasonography in 377 patients, and reassessed 2,4 weeks after surgery, and again at 6 and 12 months. Patients were instructed to contact a physician if symptoms consistent with DVT occurred before the scheduled follow-up appointment. Preoperative prophylaxis (a single dose of subcutaneous heparin) was left to the discretion of the vascular surgeon. Results: DVT was detected in 20 (5·3 per cent) of the 377 patients. Of these, only eight were symptomatic and no patient developed symptoms consistent with pulmonary embolus. Eighteen of the 20 DVTs were confined to the calf veins. Subcutaneous heparin did not alter the outcome. No propagation of thrombus was observed and half of the DVTs had resolved without deep venous reflux at 1 year. Conclusion: The incidence of DVT following varicose vein surgery was higher than previously thought, but these DVTs had minimal short- or long-term clinical significance. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

Compliance properties of conduits used in vascular reconstruction,

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 11 2000
N. R. Tai
Background Compliance mismatch between native artery and prosthetic graft used for infrainguinal bypass is implicated in the aetiology of graft failure. The aim was to quantify the elastic properties of a new compliant poly(carbonate)polyurethane (CPU) vascular graft, and to compare the compliance properties of grafts made from CPU, expanded polytetrafluoroethylene (ePTFE), Dacron and human saphenous vein with that of human muscular artery. Methods A pulsatile flow phantom was used to perfuse vessel and prosthetic graft segments at physiological pulse pressure and flow. Intraluminal pressure was measured using a Millar Mikro-tip catheter transducer and vessel wall motion was determined with duplex ultrasonography using an echo-locked wall-tracking system. Diametrical compliance and a stiffness index were then calculated for each type of conduit over mean pressures ranging from 30 to 100 mmHg by 10-mmHg increments. Results The compliance values of CPU and artery (mean over the pressure range) were similar (mean(s.d.) 8·1(0·4) and 8·0(5·9) per cent per mmHg × 10,2 respectively), although the elastic behaviour of artery was anisotropic unlike CPU, which was isotropic. Dacron and ePTFE grafts had lower compliance values (1·8(1·2) and 1·2(0·3) per cent per mmHg × 10,2 respectively, averaged over the pressure range). In both these cases, compliance and stiffness differed significantly from that of artery over a mean pressure range of 30,90 mmHg. Human saphenous vein exhibited anisotropic behaviour and, although compliant at low pressure (30 mmHg), was markedly incompliant at higher pressures. Conclusion Compliant polyurethane grafts offer a greater degree of compliance match than either ePTFE or Dacron. © 2000 British Journal of Surgery Society Ltd [source]

Effects of local arteriosclerosis on carotid baroreflex sensitivity and on heart rate and arterial pressure variability in humans

CLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING, Issue 1 2006
Ola Eiken
Summary The study examined whether the alterations in heart rate variability (HRV) and baroreflex sensitivity (BRS) observed in patients with coronary artery disease can also be discerned in otherwise healthy subjects with mild-to-moderate arteriosclerosis in the carotid artery bifurcation. Based on the results of carotid duplex ultrasonography, subjects were designated as either having no arteriosclerotic lesions (n = 18), unilateral (n = 19) or bilateral lesions (n = 18) in the bifurcation. Electrocardiograms were recorded and simultaneous and continuous records of arterial pressure were obtained. Resting HRV was determined by calculating the spectral power density in three frequency bands: 0,0·05 Hz [very low frequency (VLF) band], 0·05,0·15 [low frequency (LF) band] and 0·15,2 Hz (high frequency band), whereas the arterial pressure variability (APV) was determined from spectral power density of the VLF and LF bands. Carotid BRS was evaluated by measuring R-R intervals during application of pulse-synchronous graded pressures (40 to ,65 mmHg) in a neck-chamber device. Analysis of variance revealed no effect of mild-to-moderate carotid arteriosclerosis on the spectral components of HRV and APV or on BRS. It thus appears that mild-to-moderate asymptomatic carotid arteriosclerosis does not affect carotid BRS, APV or HRV at rest. [source]