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Unlabelled: Purposes. In this prospective study, we sought to determine the sensitivity and the specificity of arterial Doppler findings of valvular aortic stenosis (VAS)., Patients and Methods: 20 control subjects and 20 patients with various degrees of VAS underwent Doppler ultrasound of the carotids, abdominal aorta, renal arteries and limb arteries. We analyzed and compared the shape of the spectral profiles, peak systolic velocity (PSV), systolic upstroke time (SUT) and systolic upstroke index (SUI) of every tracing. The protodiastolic notch (PDN) of the common femoral arteries were recorded too., Results: VAS hardly modifies the overall shape of the Doppler spectrums of the aorta or limb arteries but it implies a biphasic deformation or a doubling of the systolic peak of the neck vessels. We also encountered biphasic profiles in renal arteries of patients with tight VAS. The PSV, SUI and depth of the PDN tend to diminish in cases of VAS but the variations are inconstant and rarely proportional to the severity of the narrowing. The increase of the SUT, on the contrary, is linearly correlated to the severity of the stenosis in every arterial system: SUTs in the common carotid artery, internal carotid artery or brachial artery that are shorter than or equal to 70 milliseconds (msec) are the obvious marks of the absence of VAS. It was not possible to differentiate between the intermediate stenoses (aortic valve area between 0.8 and 2 square centimeters) whereas critical aortic stenoses, whose area is less than or equal to 0.7 square centimeter, can be detected by the presence of at least two of the four following criteria of SUT: equal to or above 180 msec for the common carotid, 200 msec for the internal carotid, 130 msec for the aorta and 110 msec for the common femoral artery., Conclusion: During routine arterial Doppler ultrasound, a precise analysis of the spectrums and some SUT measurements allow the assessment of the aortic valve.

We present a case of post-cardiac catheterization femoral fistula diagnosed by color and pulsed Doppler sonography and treated by ultrasound-guided compression. We avail ourselves of the case to review the echo Doppler semiology of the different types of arteriovenous fistulas with an emphasis on the functional analysis of the dialysis accesses. We also stress the therapeutic options in front of undesirable shunts.

Purpose: The purpose of this study was to determine the sensitivity and specificity of arterial Doppler findings of aortic regurgitation to assess if the amplitude of changes of Doppler tracings can accurately quantify the degree of regurgitation., Patients and Methods: We analysed and compared the arterial Doppler tracings and echocardiograms of 250 patients., Results: Even if the obvious pitfall of vascular stenoses is avoided, the global sensitivity of arterial Doppler findings for aortic regurgitation remains weak (30%). However, our study demonstrates that it can reach 100% if only significant AR (> or =2/4) is taken into account. Since the clear false-positive cases have been carefully excluded from the very start, the specificity of the classical criteria already proves excellent (above 95%). It will reach perfection if additional simple criteria gathered from the data mentioned in this study are considered. Quantifying precisely the degree of aortic regurgitation on the basis of arterial Doppler tracings is impossible. Nevertheless, we show that it is easy to identify significant AR (> or =2/4) that should be further assessed with echocardiography., Conclusion: Arterial Doppler sonography is unable to detect all cases of aortic regurgitation but those that are overlooked are not significant (1/4). If AR signs happen to be detected by arterial Doppler, the amplitude of the leak cannot be accurately determined based on tracing analysis. Yet, simple criteria will indicate whether it is important enough (> or =2/4) to require complementary echocardiogram, with well documented accuracy for morphological and hemodynamic evaluation.

In most cases, ostial occlusion of the subclavian artery induces a reversal of the blood flow in the ipsilateral vertebral artery. This hemodynamic diversion is obviously brought out by Doppler ultrasound of the neck vessels. Nevertheless, when the subclavian ostial lesions are less severe or in case of anatomical variations, the alterations of the vertebral flux are more discrete. An accurate Doppler examination is then required to avoid pitfalls. In the light of a particularly complex case, we reviewed the Doppler signs of vertebral blood flow in normal conditions and in patent or less obvious subclavian steals.