Expert ultrasound angiology

Course curriculum

• Cervical segments of the carotid and vertebral arteries and transcranial examinations
  • — Doppler angle: alignment with the flow or with the wall
  • — Correct angle setting as the basis of reliable quantitative diagnosis
  • — Real cases are analyzed where the walls and flow direction do not coincide, and a 5–10° error leads to clinically significant deviations
  • — Do the specialist, the technique and the equipment create critical errors
  • — Analysis of human, technical and methodological factors that can distort the results of a duplex examination
  • — Practical approaches to self-assessment and internal quality audit
  • — Assessment of the carotid intima-media complex at the present stage
  • — Current protocols of IMT measurements, «vascular age», ASE 2008 / ESC 2021 standards
  • — Features of imaging the near and far walls, assessment of site representativeness and normal ranges
  • — Review of the IAC consensus criteria for internal carotid artery stenosis
  • — Evolution from SRU to IAC 2024, new threshold values for PSV, EDV and velocity ratios
  • — Step-by-step adaptation of the laboratory to the updated requirements
  • — Criteria for stenosis of the common, external and vertebral arteries
  • — Velocity parameters, characteristic spectra, and typical pitfalls in the assessment of the ECA and VA
  • — How to avoid over- and underestimation of stenosis in borderline segments
  • — Carotid duplex: incidental pathology
  • — Dissections, thrombi, mycotic aneurysms, radiation fibrosis and compression syndromes
  • — Reporting strategy and recommendations for the clinician
  • — Duplex assessment in Eagle syndrome
  • — The styloid process as a source of vascular compression
  • — Arterial, venous and neurogenic variants, anatomical correlates and an approach to formulating the conclusion
  • — Intracranial arteries examination protocol
  • — Complete TCD / TCI examination algorithm: MCA, ACA, PCA, BA, VA
  • — PRF settings, correction angle, MFV recording and documentation of flow directions
  • — Non-invasive assessment of intracranial hypertension
  • — Use of the pulsatility index (PI) for an approximate assessment of ICP
  • — Critical thresholds, calculation using the Bellner formula, monitoring of PI over time
• Lower extremity arteries and visceral vessels
  • — Duplex assessment of lower extremity arterial disease
  • — Protocols per ESVS 2022, stenosis criteria by PSV and Velocity Ratio
  • — Features of distal assessment and spectrum interpretation in occlusion and reconstruction
  • — Arteries after angioplasty and stenting
  • — Diagnosis of restenosis and hemodynamics in the intervention zone
  • — Comparison of velocity parameters in native and stented vessels
  • — Non-atherosclerotic diseases of the lower extremity arteries
  • — FMD, adventitial cysts, medial calcinosis, vasculitides
  • — Spectral signs, differential diagnosis, interpretation errors
  • — Duplex examination of the aortoiliac segment
  • — Technique for identifying inflow lesions
  • — PSV thresholds, VR, runoff assessment, and principles of GLASS classification
  • — Duplex examination and PAT: modern assessment of perfusion
  • — Integration of PAT (Pulse Acceleration Time) into ischemia assessment
  • — Combining PAT with ABI and WIfI for limb loss risk stratification
• Venous block
  • — Nomenclature and variants of describing venous pathology
  • — Modern CEAP terminology, compartments, saphenous and non-saphenous trunks, perforators
  • — Correct report construction and designation of reflux sources
  • — How to interpret spectra in the common femoral vein
  • — Algorithm for phasicity analysis, detection of EIV/CIV obstructions
  • — Examples of post-thrombotic changes and their reflection in the report
  • — Acute or “chronic” thrombosis
  • — Modern SRU 2018 / SFMV 2024 classification
  • — Signs of thrombus organization, recurrence criteria, wording of conclusions
  • — How to induce venous reflux
  • — Physiological maneuvers (Valsalva, augmentation, Paraná test)
  • — Time-based diagnostic thresholds for different venous segments
  • — Key information for the phlebologist
  • — The DEAR principle (Depth – Evaluation – Anatomy – Reflux)
  • — Minimum dataset for choosing ablation or sclerotherapy tactics
  • — Complications after venous interventions
  • — EHIT, PASTE, EGIT (ESVS 2022): post-ablation changes and follow-up tactics
  • — How to describe thrombosis in the coagulation zone and formulate the conclusion correctly
• Visceral and renal syndromes
  • — Superior mesenteric artery syndrome
  • — Aortomesenteric angle < 25°, distance < 8 mm, dilatation of the proximal duodenum
  • — Differentiation from MALS and external compressions
  • — MALS (Median Arcuate Ligament Syndrome)
  • — Duplex criteria for celiac trunk compression: PSV > 320 cm/s on expiration
  • — Approach to Diagnosis and Assessment of Decompression Effectiveness
  • — Diagnosis of renal artery diseases
  • — Classical criteria of stenosis (PSV ≥ 200 cm/s, RAR > 3.5)
  • — Poststenotic turbulence, tardus-parvus, monitoring of stents and grafts
  • — Fibromuscular dysplasia of the renal arteries
  • — Multifocal "string of beads" form, V₂/V₁ ≥ 2–2.5
  • — Differences from atherosclerotic stenosis and the specifics of its description
  • — Nutcracker syndrome
  • — D-ratio and V-ratio ≥ 4–5 in the presence of clinical signs
  • — Criteria for hemodynamic significance and the SVU / ESVS protocols
  • — Ultrasound assessment of the central veins
  • — VTOS, May–Thurner, IVC obstruction, pelvic venous reflux
  • — SVP classification (AVLS 2018) and pelvic vein scanning protocol