Angiology
TCD Screening in Sickle Cell Anemia: STOP Criteria (TAMMV)
TCD screening in sickle cell anemia is based on the STOP study: measuring TAMV (time-averaged mean of the maximum velocity) without angle correction in the MCA …
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Angiology
Ultrasound diagnostics of vessels: duplex scanning, velocity criteria for stenosis, protocols, and report structure.
Angiology
TCD Detection of Right-to-Left Shunt (Bubble Test) in PFO: Spencer Scale and International Consensus
Contrast-enhanced TCD (c-TCD, bubble test) detects right-to-left shunt by recording microembolic signals (MES) in the MCA after the introduction of agitated saline. The severity of the …
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Angiology
Popliteal Artery Aneurysm: Diameter Thresholds and Monitoring Strategy — What Ultrasound Physicians Need to Know
The provided source fragments lack specific diameter thresholds and monitoring algorithms specifically for popliteal artery aneurysm according to ESVS 2020. [clarify] The reliably presented data pertains …
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Angiology
Popliteal Artery Entrapment Syndrome (PAES): Provocative Duplex Tests
In PAES, the key to diagnosis is dynamic testing rather than static examination. The spectrum of the popliteal artery is recorded in a neutral position, then …
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Angiology
Cystic Adventitial Disease of the Popliteal Artery on Ultrasound: Duplex Diagnosis
Cystic adventitial degeneration (CAD) is recognized by an anechoic cyst within the wall of the popliteal artery (approximately 85% of cases), compressing the lumen from within, …
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Angiology
Thoracic Outlet Syndrome: Positional Duplex Testing
Duplex is the method of choice for demonstrating dynamic arterial compression in thoracic outlet syndrome: in a neutral position, compression may be completely absent, while positional …
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Angiology
Acute Limb Ischemia: The Role of Duplex and Rutherford Categories
In cases of acute limb ischemia, clinical assessment is urgently performed by a vascular specialist (ESVS 2020, Class I). For clinical stratification, the Rutherford classification for …
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Angiology
Toe-Brachial Index (TBI) in Non-Compressible Arteries (Diabetes, CKD): Methodology and Thresholds
In patients with diabetes and CKD (medial calcinosis), non-compressible arteries cause the ABI to appear falsely normal or high (>1.40) and do not rule out PAD. …
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Angiology
In-stent Restenosis of the Carotid Artery: Revised Velocity Thresholds
For a stented carotid artery, 'native' thresholds are inapplicable: altered compliance elevates velocities. According to Mohabat et al., significant in-stent restenosis is defined at PSV >280 …
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Angiology
Carotid Near-Occlusion ('String Sign'): Differential Diagnosis with 99% Stenosis and Occlusion in Duplex Scanning
Carotid near-occlusion (pre-occlusive stenosis, 'string sign') is a critical narrowing of the ICA with minimal residual flow appearing as a thin, slow stream. It is easily …
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Angiology
Carotid Web on Ultrasound: Signs and Association with Cryptogenic Stroke
A carotid web is a thin intraluminal projection in the region of the carotid bulb/ICA, considered a non-stenotic cause of embolic stroke in young patients without …
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Angiology
Dissection of the Internal Carotid Artery: Doppler Signs and Ultrasound Limitations
The diagnosis of spontaneous internal carotid artery (ICA) dissection using duplex scanning relies on identifying a detached intimal flap that separates true and false lumens with …
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Angiology
Vulnerable Carotid Plaque: GSM, Ulceration, and Neovascularization in CEUS
The vulnerability of a carotid plaque is assessed by its echostructure (low GSM, large juxtaluminal hypoechoic area), surface ulceration, and neovascularization via CEUS. A hypoechoic plaque …
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Angiology
Pelvic Venous Congestion: Ultrasound Criteria for Gonadal Vein Reflux
Reflux of gonadal (ovarian) veins is classified as a non-saphenous pelvic source of leakage in the classification of reflux sources. Reflux of superficial and perforating segments …
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Angiology
Post-Puncture Pseudoaneurysm of the Femoral Artery: Ultrasound Diagnosis and Thrombin Guidance
A post-puncture pseudoaneurysm of the femoral artery is a pulsating anechoic formation connected to the artery by a neck, with a bidirectional 'to-and-fro' flow in the …
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Angiology
Iatrogenic Groin AV Fistula Post-Catheterization: Doppler Signs
An iatrogenic arteriovenous fistula is a pathological connection between an artery and a vein at the site of femoral vessel puncture. In duplex, key signs include …
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Angiology
Post-EVAR Surveillance: Duplex Protocol and Endoleak Classification
After EVAR, a baseline is established in the first month (usually CTA on day 30); if there is no endoleak and no sac growth, annual duplex/CTA …
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Angiology
CEUS for Detecting Endoleaks After EVAR: Technique and Indications
CEUS is used after EVAR when there is suspicion of an endoleak or when there is growth of the aneurysmal sac with an unvisualized source on …
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Angiology
Duplex Surveillance of Infrainguinal Venous Bypass Graft: Occlusion Threat Thresholds
In an infrainguinal venous graft, both velocity poles are dangerous: PSV >300 cm/s with PSVR >3.5 indicates significant stenosis, while too low a velocity (<40–45 cm/s, …
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Angiology
Duplex TIPS: Normal Shunt Velocities and Dysfunction Indicators
Ultrasound is the primary method for TIPS surveillance. Normal velocities within the stent range from 90–190 cm/s (increasing from the portal to the hepatic end). Indicators …
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Angiology
Budd-Chiari Syndrome: Ultrasound Patterns of Hepatic Veins
Budd-Chiari Syndrome (BCS) is a global or segmental obstruction of venous outflow from the liver at the level of major hepatic veins (HV) or suprahepatic IVC. …
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Angiology
May-Thurner Syndrome: Ultrasound Signs of Compression of the Left Common Iliac Vein
May-Thurner Syndrome is a chronic compression of the left common iliac vein by the right common iliac artery with fibrosis and 'spurs.' Direct visualization of the …
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Angiology
Nutcracker Syndrome: Duplex Criteria for Left Renal Vein Compression by Velocity Gradient and D-ratio
Compression of the left renal vein in the aorto-mesenteric segment is quantitatively assessed: D-ratio (hilar/AM diameter) >4–5 and V-ratio (AM PSV/hilar PSV) >4.7–5.0. In adults, thresholds …
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Angiology
Renal Vein Thrombosis: Direct and Indirect Doppler Signs
The diagnosis of renal vein thrombosis relies on direct signs (intraluminal echogenic material, lack of vein compressibility) and indirect Doppler markers (filling defect on CD, loss …
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Angiology
Varicocele: Ultrasound Grading of Reflux and Evaluation of Pampiniform Plexus Veins
The ultrasound grading of varicocele using the Sarteschi method identifies 5 degrees (I–V) based on the presence of vein dilation, body position, and the nature of …
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Angiology
Duplex of Kidney Transplant Graft: Criteria for Transplant Renal Artery Stenosis (TRAS)
Transplant renal artery stenosis (TRAS) is recognized in duplex by focal elevation of PSV with post-stenotic turbulence, most commonly at the site of the arterial anastomosis. …
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Angiology
Renal Transplant RI: Differentiation of Rejection and Acute Tubular Necrosis
The resistive index (RI) in renal transplant dysfunction is nonspecific and clinically useless for distinguishing the causes of dysfunction or type of rejection: it increases in …
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Angiology
Duplex of the Hepatic Artery Post-Liver Transplant: Tardus-Parvus, RI, and AT
After liver transplantation, hepatic artery stenosis is suspected with a direct criterion — PSV at the anastomosis >200–250 cm/s. Indirect signs in intrahepatic arteries include parvus-tardus …
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Angiology
Mesenteric Duplex: PSV Thresholds for Celiac Trunk and SMA in Chronic Ischemia
In duplex assessment of chronic mesenteric ischemia, a significant (≥70%) stenosis of the superior mesenteric artery (SMA) corresponds to a PSV ≥275 cm/s (refined ≥400), and …
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Angiology
MALS: Respiratory Tests and Ultrasound Criteria for Celiac Trunk Compression
MALS is an extravascular compression of the celiac artery by the median arcuate ligament of the diaphragm, characterized by respiratory dynamics (intensification on exhalation). Key duplex …
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Angiology
Portal Vein Thrombosis: Benign vs Tumor — The Role of CEUS
The key to differentiation is the presence of contrast enhancement of the intravascular filling defect on CEUS. A benign (bland) thrombus does not accumulate contrast, whereas …
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Angiology
Duplex Ultrasound of Renal and Mesenteric Arteries: Stenosis According to ESVS 2025
ESVS 2025 considers duplex ultrasound as a first-line method for suspected renal artery stenosis and as an initial test for symptom recurrence after revascularization in chronic …
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Angiology
Compression Ultrasound of Lower Extremity Veins for Suspected DVT: AIUM 2024
The AIUM 2024 revision describes peripheral venous ultrasound as an examination where the main sign of DVT is incomplete vein compression; Doppler modes complement but do …
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Angiology
Peripheral Arterial Ultrasound in PAD: AIUM 2025 Protocol
In cases of intermittent claudication, peripheral arterial ultrasound according to AIUM 2025 involves grayscale, color, and spectral Doppler evaluation with documentation of waveform and velocities. For …
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Angiology
Ultrasound Screening of AAA: Diameter Thresholds and Measurement by AIUM 2025
According to AIUM 2025, an abdominal aortic aneurysm is diagnosed when the maximum outer diameter is ≥3.0 cm or when there is a local enlargement ≥1.5 …
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Angiology
Ultrasound Diagnostics in CVD: Reflux Criteria and Venous Mapping ESVS 2022
According to ESVS 2022, duplex ultrasound is the primary imaging method for chronic venous disease of the lower limbs. Pathological reflux is assessed by the duration …
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Angiology
How to Learn Vascular Ultrasound: Training Formats, CME, and Retraining
The source fragments do not contain data on the formats of training doctors in vascular ultrasound, professional retraining programs, or the accrual of CME credits [clarify]. …
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Angiology
ICA PSV for 50–69% and ≥70% Stenosis: SRU/IAC 2024 Criteria
According to the original SRU criteria, ICA stenosis of 50–69% corresponds to a PSV of 125–230 cm/s, and stenosis ≥70% corresponds to a PSV >230 cm/s. …
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Angiology
Vascular Doppler Device Setup: Checklist for Optimizing Angle, PRF, Wall Filter, and Gain
Optimizing vascular Doppler involves several controllable parameters: insonation angle ≤60°, PRF (scale) adjusted to expected velocities to eliminate aliasing, low wall filter to preserve diastole, and …
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Angiology
Ultrasound Monitoring of AV Fistula for Hemodialysis: Mapping, Volume Blood Flow, and Maturation Criteria
Preoperative ultrasound mapping increases the success rate of AV fistula formation: the artery for anastomosis should be ≥2 mm, and the vein ≥2.5 mm (after dilation). …
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Angiology
Duplex Ultrasound of Upper Extremity Arteries: Protocol and Stenosis Criteria
According to the AIUM 2025 parameter for peripheral arterial ultrasound, the key quantitative logic for stenosis is the ratio of PSV at the narrowing zone to …
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Angiology
Post-Puncture Pseudoaneurysm: Ultrasound Criteria and Measurements
When suspecting a post-puncture pseudoaneurysm, ultrasound must confirm communication with the artery: turbulent color flow in the cavity and a 'to-and-fro' spectral signal in the neck. …
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Angiology
Upper Extremity Venous Thrombosis: Segmental Ultrasound Protocol
When suspecting upper extremity venous thrombosis, ultrasound should assess the deep and, if indicated, superficial venous systems: internal jugular, subclavian, axillary, brachial veins, as well as …
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Angiology
Arterial Shunt on Ultrasound: Restenosis Criteria and Control Points
For duplex monitoring of peripheral arterial shunt, key AIUM 2025 thresholds are: focal PSV >300 cm/s, PSV ratio at stenosis to pre-stenotic PSV >3.5, and diffusely …
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Angiology
Transcranial Duplex Scanning (TCCS): Velocity Norms, Lindegaard Ratio, and Vasospasm Assessment
TCCS (TCCS/TCCD) combines B-mode, color flow mapping, and spectral Doppler to assess the arteries at the base of the brain. Mean flow velocities (MFV) and their …
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Angiology
Duplex of Renal Arteries: Location Points and Stenosis Criteria (RAR, PSV, tardus-parvus, RI)
Renal artery duplex combines direct criteria (PSV in the stenosis zone >180–200 cm/s, RAR ≥3.5) and indirect criteria (AT >70–100 ms, tardus-parvus, decreased RI on the …
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Angiology
Ultrasound Screening of Abdominal Aortic Aneurysm: Diameter Measurement and Referral Criteria to a Surgeon
AAA is defined as an aortic diameter ≥3.0 cm or an enlargement more than 1.5 times the reference diameter (SVS). The diameter is measured perpendicular to …
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Angiology
Duplex Ultrasound of Lower Extremity Arteries: Protocol, ABI Calculation, and Ultrasound Staging of Ischemia
The diagnosis of PAD begins not with the probe, but with the Ankle-Brachial Index (ABI): a threshold of <0.90 confirms the disease, >1.40 indicates non-compressibility (then …
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Angiology
Venous Reflux of the Lower Extremities: Provocative Tests, Pathological Reflux Thresholds, and Valve Assessment
Pathological reflux is diagnosed during a standing ultrasound (lying down is unacceptable) with mandatory provocation: the Valsalva maneuver for the saphenofemoral junction (SFJ) and distal compression …
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Angiology
CEAP Classification in Practice: Correct Coding and Formulation in Ultrasound Reporting
CEAP is the most widely used descriptive tool for chronic venous disorders (ESVS 2024), encoding four domains: clinical (C), etiological (E), anatomical (A), and pathophysiological (P). …
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Angiology
Diagnosis of DVT on Ultrasound: Compression Test, Signs of Acute and Floating Thrombus, Common Mistakes
Duplex with compression test is the gold standard for diagnosing DVT. A normal vein completely collapses under transverse compression, whereas a vein with a thrombus does …
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Angiology
Doppler Ultrasound of Lower Limb Veins: Point Protocol and Ready-Made Report Template
Doppler ultrasound of lower limb veins relies on precise anatomy and unified nomenclature: correct localization and naming of the vessel determine the diagnosis and phlebologist's strategy. …
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Angiology
Intima-Media Thickness (IMT): Measurement Technique, Norms, and Difference from Plaque
IMT is measured on the far wall of the CCA, ~1 cm proximal to the bifurcation, in a straight segment without plaques, strictly at the end …
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Angiology
Degree of ICA Stenosis: Duplex Velocity Criteria (PSV, EDV, ICA/CCA) vs NASCET/ECST and SRU Consensus
The degree of ICA stenosis in duplex is assessed by hemodynamics (PSV, EDV, ICA/CCA ratio, turbulence), whereas the anatomical percentage by NASCET/ECST is established by imaging …
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Angiology
Protocol for Duplex Scanning of the BCA: Location Points, Modes, Norms, and Report Structure
Duplex scanning of the brachiocephalic arteries requires a systematic reproducible protocol: bilaterally assessing the CCA, ICA, ECA, vertebral artery at the mid-neck level, proximal segment of …
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Angiology
Velocity Criteria for ICA Stenosis: PSV, EDV, and ICA/CCA Table (IAC 2021)
The degree of ICA stenosis is determined by a combination of PSV, ICA/CCA ratio, EDV, and post-stenotic turbulence. The PSV threshold for ≥50% is 180 cm/s, …
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Angiology
Doppler Ultrasound of Lower Extremity Veins: Examination Protocol and Report Structure
Doppler ultrasound of lower extremity veins for suspected reflux is performed using a linear transducer of 7–12 MHz in a vertical position with mandatory provocation: Valsalva …
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