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What is a Vascular Ultrasound?

A vascular ultrasound is also known as a duplex ultrasound or doppler ultrasound and is a specialized type of ultrasound imaging that is used to evaluate the blood flow and circulation in the arteries and veins of the body. It combines traditional ultrasound imaging with doppler ultrasound technology, allowing healthcare providers to visualize and assess blood flow patterns in real-time.

Vascular ultrasound uses sound waves to see your arteries and veins. It is a harmless and safe technology that does not use radiation and does not require injection of any chemicals.

What You Can Expect

Preparation

The patient may be asked to change into a gown depending on the area being examined and will be positioned on an examination table, either lying down or sitting, depending on the area to be examined.

Exam

A clear gel is applied to the skin over the area to be examined and then the sonographer then places the transducer over the gel-covered skin in the area of interest.

Documentation

The sonographer captures images of the structures of interest during the examination. These images are stored electronically for review by a radiologist or interpreting physician.

Interpretation

After the images are acquired, a radiologist or interpreting physician reviews the images to make a diagnosis or assess the condition being evaluated and are communicated to the patient by a healthcare provider.

Why Vein & Vascular Institute?

The Vein & Vascular Institute is known for its leading-edge ultrasound and imaging facility. Over 50,000 satisfied patients have been tested across our three convenient locations. 

At our accredited center for ultrasound and imaging, we pride ourselves on offering a comprehensive range of diagnostic services tailored to meet the diverse needs of our patients. With a commitment to excellence, compassion, and innovation, we strive to provide accurate diagnoses and personalized care that prioritize the well-being of every individual who walks through our doors.

The Vein & Vascular Institute is fully equipped with a Vascular Lab, staffed by full-time Registered Vascular Technologists (RVTs), in all four of our locations.


The Vein & Vascular Insitute is proud to have repeatedly achieved the highly acclaimed IAC Vascular Testing accreditation in both venous and arterial testing. You can be assured with this IAC designation and its stringent requirements you are receiving the highest quality in Vascular Testing.

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Investigate Your Venous and Arterial Symptoms Today

Trusted by Patients

The entire experience was pleasant and informative. In addition to making me feel comfortable, Dr. Dietzek ensured that I understood his findings. He also gave his opinion on the next steps I should take. Having personally experienced Vein & Vascular Institute, I would recommend it to others.
Everyone was very nice, didn't have to wait long and I got an answer for my problem.
I see Dr. Fakhoury on a weekly basis, for the past year...his knowledge is amazing as is his bedside manner. The staff, from the front desk, to the nurses and doctors, to the people behind the scenes...more like family to me.
Excellent staff! Highly recommended!
Pleasant professional experience with Erika. Staff was very nice. Highly recommend this practice.
A very enjoyable experience. Very pleasant & thorough staff!
Erika Dietzek, APN and staff were extremely professional, personable, and caring during the sclerotherapy procedure.Highly recommended V&VI for medical and cosmetic services!
Another excellent procedure with Dr. Fakhoury and his staff is friendly and professional.
Everyone was very knowledgeable, professional, and extremely friendly. I felt comfortable every step of the way and will definitely recommend them to others
My experience was great. I had been to Dr. Dietzek almost 10 years ago. I would highly recommend him to clear up any unsightly veins.
The staff is very friendly and helpful.
A quick professional visit with time spent explaining details ,a good experience!!
Very friendly, professional and great office staff. 5 stars for sure. So happy how my procedures are going. I had some tough veins I’ve let go for over 30 yrs. I highly recommend them. Erika is awesome made me feel so comfortable. Can’t wait to see my final results when I’m finished with this process. 💕
Erica and Dr Dietzek explain everything really well. Very polite and professional!
I enjoy coming to this place. It's very calming and easy to get to.
Competent staff, answered all my questions, and very professional.
They are friendly, and explained my worries very clear.
Extremely helpful, professional, and as for Dr Dietzak, they don't make them any better then him
Staff very friendly and professional. Dr. Dietzek very caring, knowledgeable, best at what he does.
This has to be the best experience I’ve ever had at a doctors office. You really are cared for and not just another patient.
Everyone was so nice and very informative. All of my questions were answered. Dr. Fakhoury made me feel comfortable & took the extra time and steps to ensure the procedure I need done could be completed safely.
Very thorough and explained everything fully.
Nurse practitioner was thorough and informative. She explained what was going on with my legs and I have a better understanding of what to do next.
I was very impressed with the Vein and Vascular Institute. Everyone was very professional and knowledgeable, even when confronted with the quirky little problem that I presented with. Looking forward to having all my vein issues addressed here!
First time I was there as a patient, all the staff from customer service to the Doctor were so nice which made my visit pleasant and painless.
Great work. Very professional and made it as easy as possible.
Great place! People are so nice! And my legs look great!
Everyone is so nice and very knowledgeable everything they told me went as planned procedure came out incredibly well can not tell i had a procedure done
Erika was very good with explaining the expectations of the procedure. Staff and friendly and took their time to answer questions.
Staff and Doctors were very helpful and kind!
Great experience! Staff is welcoming and very thorough!
Everyone was very helpful, kind and friendly
Appointment was made promptly everyone I spoke to on the phone and in their office were wonderful and very helpful.
I was examined by Dr. Elias Fakhoury, who performed a GSV Clarivein Venous Closure procedure on my right lower leg last year due to Venous Insufficiency. Dr. Fakhoury will perform a Venous Closure procedure on my left lower leg in the very near future. During this visit a thorough Ultrasound of both legs was performed. A detailed medical history was performed by Alyssia, and Dr. Fakhoury examined both of my legs, as well as to explain the Venous Closure procedure he will perform on my left leg. Everyone, from the front office staff to the Ultrasound specialist, to Alyssia, to Dr. Fakhoury were extremely pleasant, helpful, and knowledgeable about my leg condition. I look forward to another successful Venous Closure performed by Dr. Fakhoury.
The staff was kind and professional. The only part I say I had a problem with is not being informed I should have purchased compression stockings instead I was recommended to purchase them at an additional $60. Which I could have purchased from Amazon for a fraction of the price. I actually believe they should be incorporated in the amount of procedure. Other than that The NPC was fantastic.. 🤞🏼 I’m hoping I will heal great..
Staff is very friendly, helpful and willing to answer questions. Appointments move quickly with little wait/downtime. Would strongly encourage family and friends to see them.
Dr. Dietzek is very knowledgeable and courteous and professional. His staff is also excellent.
Exceptional service. Made me feel like I mattered.
My experience was pleasant. I felt relaxed. Every detail was explained to me. I definitely recommend the Vein & Vascular Institute.
Dr. Dietzek is easy to talk to and explains everything in a way that I can understand. The entire office staff is friendly and welcoming. I was really nervous when I got there (I'm always nervous at the doctor's) but I feel better going back for future appointments.
Quick in and out. Very professional, clearly explaining. Would recommend.
Very informative consultation. I feel very positive moving forward with my vein treatment plan.
The staff was really nice and the doctor we're very sympathetic to my recent loss of my son. There wasn't too long of a wait which was nice
This place is the best I highly recommend this place the Doctors and staff are very friendly and very knowledgeable so I felt very comfortable in allowing them to the treatments on me.
I have been a patient of Dr. Dietzeck since 2009. I was ASTOUNDED how my spider veins disappeared after my treatment. I go back every couple years to maintain my result because of my occupation as a hair stylist I am on my feet for long periods. The staff is very informative and patient explaining your at home instructions. I have recommended him to many of my clients and friends and they all were very pleased. Dr. Dietzeck’s office is unique and professional you can feel the difference as soon as you walk in!
The staff is very personable and professional. I highly recommend Erika for the sclerotherapy procedure!
Excellent customer service , staff is very friendly . Physicians are very knowledgeable, highly recommended
Had a very pleasant experience here. Everyone was very friendly and professional. My appointment was late in the day on a Friday which is odd for any doctor’s office and none of the staff acted frustrated or anxious to leave. It was amazing. Very thorough and explained everything to me. Very pleased.
A very satisfying experience. Dr Dietzak n staff excellent group.
Dr. Dietzik was wonderful! Scleratherapy restored my legs and hands to there once youthful appearance! I am so pleased with the results! Thank you to everyone who made my experience at the Vein and Vascular Institute so amazing!Laura S.
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We offer the following screenings (non exhaustive) to examine various areas of the body:

Please click one of the tabs below

Abdominal aorta ultrasound
Ankle/brachial Indices (ABI) ultrasound
Aorta iliac ultrasound
Arterial duplex ultrasound – legs
Carotid duplex ultrasound
Saphenous vein mapping ultrasound
Standing Venous duplex ultrasound – legs
Upper extremity DVT
Upper extremity vein mapping
Varicose vein surgery pre-op survey
Varicose vein surgery post-op evaluation
Venous insufficiency/swelling
Visceral

Abdominal aorta screening ultrasound is a diagnostic imaging technique used to examine the abdominal aorta, the largest artery in the abdominal cavity, for potential abnormalities, primarily abdominal aortic aneurysms (AAA). It is a non-invasive procedure that utilizes high-frequency sound waves (ultrasound) to create real-time images of the abdominal aorta and surrounding structures.

During the ultrasound examination, a trained technician, often called a sonographer, places a gel on the abdomen to facilitate the transmission of sound waves. They then use a handheld device called a transducer, which emits sound waves and receives the echoes bouncing back from the tissues inside the body. These echoes are processed by a computer to generate detailed images of the abdominal aorta on a monitor.

The purpose of abdominal aorta screening ultrasound is to detect any abnormal widening or bulging of the abdominal aorta, which could indicate the presence of an AAA. AAAs are a serious medical condition characterized by the weakening and dilation of the abdominal aortic wall. If left untreated, AAAs can rupture, leading to life-threatening internal bleeding.

Screening ultrasounds are typically recommended for individuals at higher risk of developing AAA, such as older adults, especially men over 65 years old, individuals with a history of smoking, hypertension, or a family history of AAA. However, screening recommendations may vary depending on the guidelines of different healthcare organizations.

Abdominal aorta screening ultrasound is an important tool in preventive medicine because it allows for the early detection of AAAs, enabling healthcare providers to implement appropriate interventions, such as surveillance, lifestyle modifications, or surgical repair, to prevent rupture and its potentially fatal consequences. Early detection and management of AAAs can significantly improve patient outcomes and reduce mortality rates associated with this condition.

Ankle-Brachial Indices (ABI) ultrasound is a diagnostic test used to evaluate peripheral arterial disease (PAD), a condition characterized by narrowing or blockage of the arteries in the limbs, particularly the legs. The ABI test compares blood pressure measurements taken at the ankle with those taken at the arm (brachial artery) to assess the blood flow in the lower extremities relative to that in the upper extremities.

Here’s how the ABI ultrasound procedure typically works:

  1. Preparation: The patient lies down comfortably on an examination table. Blood pressure cuffs are placed around both arms and both ankles.
  2. Blood Pressure Measurement: A healthcare provider or technician uses a handheld Doppler ultrasound device to detect blood flow in the arteries of the arms and ankles. They place the Doppler probe over the brachial artery in the arm and then over the posterior tibial artery and dorsalis pedis artery in each ankle.
  3. Blood Pressure Recording: Blood pressure measurements are taken at each location using the Doppler probe and a blood pressure cuff. The systolic blood pressure is recorded at each site.
  4. Calculation of ABI: The ankle systolic blood pressure is divided by the higher of the two brachial systolic blood pressures to calculate the ABI for each leg. The ABI is calculated separately for each leg.

The normal ABI value typically falls between 0.90 and 1.30. An ABI below 0.90 is generally considered indicative of PAD, with lower values indicating more severe disease. An ABI above 1.30 may suggest non-compressible arteries, often seen in individuals with diabetes or calcified arteries.

ABI ultrasound is valuable for diagnosing PAD, assessing disease severity, and guiding treatment decisions. It helps healthcare providers evaluate the risk of complications such as leg ulcers, gangrene, and amputation, and it assists in developing personalized management plans for patients with PAD. Additionally, ABI testing is non-invasive, relatively quick, and well-tolerated by patients, making it a widely used diagnostic tool in vascular medicine.

Aorta iliac ultrasound, also known as abdominal aorta and iliac artery ultrasound, is a diagnostic imaging procedure used to assess the abdominal aorta and its branches, particularly the iliac arteries. This non-invasive test utilizes high-frequency sound waves (ultrasound) to produce real-time images of the blood vessels in the abdomen and pelvis.

Aorta iliac ultrasound is commonly used for various clinical purposes, including:

  • Screening for abdominal aortic aneurysms (AAA) in asymptomatic individuals, particularly those at higher risk (e.g., older adults, smokers, individuals with a family history of AAA).
  • Diagnosing and monitoring vascular diseases affecting the abdominal aorta and iliac arteries, such as atherosclerosis, thrombosis, or dissection.
  • Planning and guiding interventions or surgeries, such as endovascular repair of aortic aneurysms or angioplasty for iliac artery stenosis.

Overall, aorta iliac ultrasound is a valuable tool in vascular medicine, providing important diagnostic information that guides patient management and treatment decisions while being safe, non-invasive, and well-tolerated by patients.

Arterial duplex ultrasound of the legs is a non-invasive diagnostic imaging test used to evaluate the blood flow and anatomy of the arteries in the lower extremities. It combines two types of ultrasound techniques: Doppler ultrasound and B-mode ultrasound (also known as duplex ultrasound), hence the term “duplex.”

Here’s an overview of the procedure:

  1. Preparation: The patient typically lies down on an examination table, and the area to be examined (usually the legs) is exposed. There is usually no specific preparation required for this test, although it’s advisable to wear loose-fitting clothing that can be easily rolled up or removed if necessary.
  2. Application of Gel: A clear, water-based gel is applied to the skin over the legs. This gel helps to facilitate the transmission of sound waves and ensures good contact between the skin and the ultrasound transducer.
  3. Ultrasound Examination: A trained ultrasound technician (sonographer) or healthcare provider uses a handheld ultrasound probe called a transducer to capture images of the blood vessels in the legs. The transducer emits high-frequency sound waves that penetrate through the skin and bounce back (echo) when they encounter blood flowing within the arteries. The Doppler effect is used to detect the speed and direction of blood flow, while the B-mode ultrasound provides real-time images of the artery walls and surrounding tissues.
  4. Image Acquisition: The technician or healthcare provider moves the transducer along the surface of the skin, systematically scanning the arteries in the legs from various angles. They assess the size, shape, and blood flow characteristics of the arteries, looking for any abnormalities such as narrowing (stenosis), blockages (occlusions), or plaques (atherosclerosis).
  5. Interpretation: The ultrasound images and Doppler waveforms are analyzed to evaluate the blood flow patterns, detect any abnormalities, and assess the severity of vascular disease. The findings are interpreted by a radiologist or vascular specialist, who provides a report to the referring healthcare provider.

Arterial duplex ultrasound of the legs is a valuable tool in vascular medicine, providing important diagnostic information that guides patient management and treatment decisions. It is safe, non-invasive, and well-tolerated by patients.

Carotid duplex ultrasound is a sophisticated diagnostic tool used to evaluate the carotid arteries, vital blood vessels in the neck that supply oxygen-rich blood to the brain. This non-invasive imaging procedure combines B-mode ultrasound and Doppler ultrasound techniques to provide detailed information about the structure and function of the carotid arteries. In this comprehensive guide, we will explore the purpose, procedure, significance, and potential findings of carotid duplex ultrasound.

The primary purpose of carotid duplex ultrasound is to assess the presence and severity of carotid artery disease, including atherosclerosis and stenosis. By evaluating the structure of the artery walls, detecting the presence of plaque buildup, and measuring blood flow velocity, carotid duplex ultrasound helps healthcare providers identify individuals at risk for stroke or transient ischemic attack (TIA). Additionally, it plays a crucial role in guiding treatment decisions and interventions aimed at reducing the risk of stroke.

During a carotid duplex ultrasound examination, the patient typically lies comfortably on an examination table in a slightly reclined position. A clear, water-based gel is applied to the skin over the neck area where the carotid arteries are located to facilitate sound wave transmission. A trained ultrasound technician or healthcare provider then uses a handheld ultrasound transducer to capture images and Doppler waveforms of the carotid arteries. The examination involves systematically scanning both sides of the neck to assess the size, shape, and integrity of the artery walls, as well as the presence of any plaques or areas of stenosis. Doppler measurements are taken to evaluate blood flow velocity and detect abnormalities in blood flow patterns.

Carotid duplex ultrasound is a valuable diagnostic tool in vascular medicine, providing essential information for the assessment and management of carotid artery disease. Through early detection, risk stratification, and guided interventions, carotid duplex ultrasound plays a crucial role in reducing the burden of stroke and improving patient outcomes. Healthcare providers should consider incorporating carotid duplex ultrasound into routine clinical practice, particularly for individuals at risk for cerebrovascular events.

Saphenous vein mapping ultrasound is a diagnostic procedure used to assess the anatomy and patency of the saphenous veins in the lower extremities. It is commonly performed prior to vein harvesting for surgical procedures such as coronary artery bypass grafting (CABG) or peripheral vascular bypass surgery. Here’s a step-by-step guide on how to perform a saphenous vein mapping ultrasound:

  1. Patient Preparation:
    • Explain the procedure to the patient and obtain informed consent.
    • Ensure the patient is lying comfortably on the examination table in a supine position.
    • Expose the lower extremities, particularly the thigh and calf regions, where the saphenous veins are located.
  2. Equipment Setup:
    • Use a high-frequency ultrasound probe suitable for vascular imaging.
    • Ensure the ultrasound machine is properly calibrated and set to the appropriate settings for vascular imaging.
  3. Probe Placement:
    • Begin by identifying the saphenous vein at its proximal origin in the groin region. The greater saphenous vein (GSV) typically originates from the saphenofemoral junction (SFJ), while the lesser saphenous vein (LSV) originates from the popliteal vein.
    • Place the ultrasound probe transversely or longitudinally over the groin area to visualize the SFJ and the proximal segment of the GSV.
    • Apply gentle pressure with the probe to compress the vein and confirm its compressibility, which is a characteristic feature of veins on ultrasound imaging.
  4. Scanning Technique:
    • Slowly move the ultrasound probe distally along the course of the saphenous vein, tracing its path through the thigh and calf regions.
    • Use both transverse and longitudinal scanning planes to visualize the entire length of the saphenous vein, including any tributaries or branches.
    • Rotate and tilt the ultrasound probe as needed to obtain optimal imaging views of the saphenous vein and surrounding structures.
    • Use color Doppler ultrasound to assess blood flow within the saphenous vein and detect any areas of stenosis, thrombosis, or abnormal flow patterns.
  5. Documentation:
    • Record images and video clips of the saphenous vein mapping procedure, documenting the anatomy, size, and patency of the vein.
    • Measure the diameter of the saphenous vein at various locations along its course, including the SFJ, mid-thigh, knee, and calf regions.
    • Document any abnormalities or findings suggestive of venous insufficiency, such as reflux or venous wall thickening.
  6. Interpretation and Reporting:
    • The ultrasound findings are interpreted by a radiologist or vascular specialist, who assesses the anatomy, patency, and suitability of the saphenous vein for surgical harvesting.
    • A comprehensive report is generated, detailing the findings of the saphenous vein mapping ultrasound and providing recommendations for further management or surgical planning.
  7. Clinical Applications:
    • Saphenous vein mapping ultrasound is used to identify suitable segments of the saphenous vein for harvesting in vascular surgical procedures such as CABG or peripheral vascular bypass surgery.
    • It helps guide surgical planning and decision-making, ensuring the selection of high-quality veins with adequate diameter and patency for grafting purposes.

In summary, saphenous vein mapping ultrasound is a valuable tool in vascular surgery, providing detailed anatomical and hemodynamic information about the saphenous veins in the lower extremities. By accurately assessing vein morphology and patency, it helps optimize surgical outcomes and minimize complications in patients undergoing vascular procedures.

Venous duplex ultrasound of the legs is a non-invasive diagnostic imaging procedure used to evaluate the venous system of the lower extremities. This imaging technique combines B-mode ultrasound and Doppler ultrasound to visualize the anatomy of the leg veins and assess blood flow characteristics. Here’s an overview of venous duplex ultrasound of the legs:

1. Patient Preparation:

  • The patient is typically instructed to wear loose-fitting clothing to facilitate access to the legs.
  • No special preparation, such as fasting, is usually required before the procedure.

2. Equipment Setup:

  • A high-frequency ultrasound transducer is used for imaging the superficial and deep veins of the legs.
  • The ultrasound machine is equipped with both B-mode and Doppler capabilities for anatomical visualization and blood flow assessment.

3. Imaging Protocol:

  • The ultrasound technologist or healthcare provider applies ultrasound gel to the skin overlying the legs to facilitate sound wave transmission and minimize air interference.
  • The transducer is then placed sequentially along the course of the leg veins, including the common femoral vein, femoral vein, popliteal vein, and calf veins.
  • B-mode ultrasound is used to visualize the veins, identify any abnormalities such as thrombus or venous dilation (varicose veins), and measure vein diameter.
  • Doppler ultrasound is employed to assess blood flow within the veins, detect venous reflux (backward flow), and measure blood flow velocities.
  • Color Doppler ultrasound may be used to provide additional information about blood flow direction and velocity, particularly in cases of venous insufficiency or deep vein thrombosis (DVT).

4. Evaluation:

  • The ultrasound examination evaluates several key parameters, including:
    • Anatomy of the leg veins: Assessing for the presence of varicose veins, venous dilation, or venous malformations.
    • Venous patency: Detecting any obstruction or narrowing of the veins that may impede blood flow.
    • Venous reflux: Assessing for the presence and severity of venous valve incompetence, which can lead to venous insufficiency and chronic venous disease.
    • Thrombus detection: Identifying the presence of acute or chronic thrombus (blood clot) within the veins, which may indicate deep vein thrombosis (DVT).

5. Interpretation and Reporting:

  • The ultrasound findings are interpreted by a radiologist or vascular specialist.
  • A comprehensive report is generated, documenting the status of the leg veins, any detected abnormalities or pathology, and recommendations for further management or intervention.

6. Clinical Applications:

  • Venous duplex ultrasound of the legs is used in the diagnosis and management of various venous disorders, including chronic venous insufficiency, varicose veins, venous thrombosis (DVT), and venous ulcers.
  • It helps guide treatment decisions, such as compression therapy, endovenous ablation procedures, or anticoagulant therapy, based on the underlying venous pathology identified on imaging.

Upper extremity deep vein thrombosis (DVT) refers to the formation of blood clots within the veins of the arms, including the axillary, brachial, radial, and ulnar veins. While DVT commonly occurs in the lower extremities, particularly the deep veins of the legs, it can also affect the upper extremities, though less frequently. Upper extremity DVT can lead to significant morbidity and complications if left untreated. Here’s an overview of upper extremity DVT:

Causes:

  1. Venous Stasis: Reduced blood flow within the upper extremity veins can occur due to various factors such as immobility, prolonged sitting or standing, or conditions that impede venous return.
  2. Vascular Injury: Trauma to the veins, such as catheter insertion, surgery, or direct injury, can predispose to the formation of blood clots.
  3. Hypercoagulable States: Certain medical conditions or risk factors can increase the risk of blood clot formation, including inherited thrombophilias, malignancy, hormonal therapy (e.g., estrogen-containing contraceptives), or systemic inflammatory disorders.

Symptoms:

  1. Arm Swelling: Swelling of the affected arm, often accompanied by pain or discomfort, is a common symptom of upper extremity DVT.
  2. Arm Pain: Patients may experience pain or tenderness along the course of the affected veins, which may worsen with movement or palpation.
  3. Warmth and Redness: The skin overlying the affected area may feel warm to the touch and appear red or discolored due to inflammation.
  4. Visible Veins: In some cases, dilated or engorged veins may be visible on the surface of the skin, particularly in the area where the clot is located.

Complications:

  1. Pulmonary Embolism: A blood clot in the upper extremity veins can dislodge and travel through the bloodstream to the lungs, causing a potentially life-threatening pulmonary embolism.
  2. Post-Thrombotic Syndrome: Chronic venous insufficiency and persistent symptoms such as pain, swelling, and skin changes may occur in some patients following resolution of the acute thrombotic event.
  3. Recurrent Thrombosis: Individuals with upper extremity DVT may be at increased risk of recurrent thrombosis, particularly if underlying risk factors are not adequately addressed or managed.

Diagnosis:

  1. Ultrasound Imaging: Duplex ultrasound of the upper extremity veins is the primary diagnostic modality for detecting and confirming the presence of DVT. It allows visualization of the veins and identification of intraluminal blood clots.
  2. Venography: In some cases, venography may be performed to provide detailed imaging of the upper extremity veins and assess the extent of thrombus involvement, particularly in complex or recurrent cases.

Treatment:

  1. Anticoagulation: The mainstay of treatment for upper extremity DVT is anticoagulant therapy to prevent clot propagation and reduce the risk of complications such as pulmonary embolism.
  2. Thrombolysis: In select cases of extensive or symptomatic upper extremity DVT, thrombolytic therapy may be considered to dissolve the clot and restore venous patency.
  3. Vascular Interventions: Endovascular procedures such as catheter-directed thrombolysis or mechanical thrombectomy may be employed in cases of severe or refractory upper extremity DVT to remove the clot and restore venous flow.

In summary, upper extremity DVT is a potentially serious condition characterized by the formation of blood clots within the veins of the arms. Prompt diagnosis and appropriate treatment are essential to prevent complications and optimize outcomes in affected individuals.

  • Upper extremity vein mapping

A pre-operative survey using ultrasound for varicose vein surgery involves the use of ultrasound imaging to assess the anatomy and hemodynamics of the veins affected by varicose veins before undergoing surgical intervention. This survey helps the healthcare team plan the surgical approach, determine the extent of venous reflux or obstruction, and identify any underlying venous pathology that may impact the surgical outcome. Here’s an overview of the pre-operative survey process:

1. Patient Evaluation:

  • The patient’s medical history, symptoms, and risk factors for venous insufficiency or varicose veins are assessed.
  • A physical examination of the lower extremities is performed to evaluate the extent of varicose veins, skin changes, and signs of venous insufficiency.

2. Ultrasound Imaging:

  • Duplex ultrasound imaging is the primary modality used for the pre-operative survey of varicose veins.
  • Ultrasound allows for real-time visualization of the superficial and deep veins, assessment of venous reflux, identification of incompetent perforator veins, and detection of any associated venous thrombosis or obstruction.
  • Color Doppler ultrasound is used to assess blood flow direction and velocity within the veins, while B-mode ultrasound provides detailed anatomical information about vein size, wall morphology, and presence of thrombus.

3. Venous Mapping:

  • The ultrasound technician or vascular specialist performs a systematic evaluation of the lower extremity veins, including the great saphenous vein, small saphenous vein, perforator veins, and tributary veins.
  • Vein mapping involves measuring vein diameter, assessing for reflux or retrograde flow, and identifying sites of venous insufficiency or incompetence.
  • Venous mapping helps guide the selection of appropriate treatment options, such as endovenous ablation, sclerotherapy, or surgical vein ligation and stripping.

4. Assessment of Venous Anatomy:

  • Ultrasound imaging helps assess the anatomical variation of the venous system, such as the presence of duplicated or accessory veins, venous tributaries, and venous anomalies.
  • Understanding the venous anatomy is essential for planning the surgical approach and ensuring complete treatment of varicose veins while minimizing the risk of complications.

5. Documentation and Surgical Planning:

  • The findings of the pre-operative survey are documented in a comprehensive report, which includes details about vein anatomy, reflux patterns, presence of thrombus or obstruction, and any associated venous pathology.
  • Based on the ultrasound findings, the surgical team develops a tailored treatment plan for varicose vein surgery, selecting the most appropriate techniques and interventions to address the patient’s specific venous pathology and clinical needs.

In summary, a pre-operative survey using ultrasound for varicose vein surgery plays a crucial role in evaluating venous anatomy, identifying pathological changes, and guiding surgical planning to achieve optimal outcomes for patients with varicose veins.

Performing a post-operative evaluation of varicose vein surgery using ultrasound can provide valuable insights into the surgical outcomes, assess for any residual venous abnormalities, and detect potential complications. Here’s how ultrasound can be utilized in the post-operative evaluation:

1. Assessment of Surgical Sites:

  • Ultrasound imaging is used to visualize the surgical sites and evaluate the integrity of the treated veins, including the great saphenous vein (GSV) or small saphenous vein (SSV) if they were targeted during the surgery.
  • The presence of residual varicosities, venous reflux, or incomplete vein closure (in cases of endovenous ablation procedures) can be assessed.

2. Detection of Hematomas or Fluid Collections:

  • Ultrasound can detect the presence of hematomas or seromas at the surgical sites, which may indicate post-operative bleeding or fluid accumulation.
  • Color Doppler imaging can help differentiate between vascular and non-vascular fluid collections.

3. Evaluation of Venous Flow and Patency:

  • Duplex ultrasound is utilized to assess venous flow patterns and detect any abnormalities such as venous obstruction, thrombosis, or residual reflux.
  • Venous patency is assessed by visualizing the flow within the treated veins and assessing for any flow disturbances or stenosis.

4. Identification of Complications:

  • Ultrasound can help identify complications such as deep vein thrombosis (DVT), superficial thrombophlebitis, or venous injury that may occur as a result of the surgical procedure.
  • Compression ultrasound may be performed to assess for the presence of compressible veins and rule out DVT in patients with suspected symptoms or risk factors.

5. Comparison with Pre-operative Findings:

  • Post-operative ultrasound findings are compared with pre-operative imaging studies to evaluate the effectiveness of the surgical intervention and assess for any changes in venous anatomy or hemodynamics.
  • Any discrepancies between pre-operative and post-operative findings are noted and may prompt further evaluation or intervention.

6. Follow-up Monitoring:

  • Follow-up ultrasound examinations may be scheduled at regular intervals to monitor the progress of healing, assess for resolution of any residual venous abnormalities, and ensure long-term success of the surgical treatment.
  • Patient symptoms and clinical findings are correlated with ultrasound findings to guide ongoing management and optimize patient outcomes.

In summary, ultrasound imaging plays a crucial role in the post-operative evaluation of varicose vein surgery, providing detailed assessment of the surgical outcomes, detection of complications, and guidance for further management as needed.

Venous insufficiency and swelling can be assessed using ultrasound imaging techniques, particularly venous duplex ultrasound, which combines B-mode ultrasound and Doppler ultrasound to visualize the anatomy of the veins and assess blood flow characteristics. Here’s how venous insufficiency and swelling are evaluated using ultrasound imaging:

1. Venous Duplex Ultrasound:

  • Venous duplex ultrasound is a non-invasive imaging modality used to evaluate the venous system of the lower extremities.
  • It combines two modes of ultrasound imaging: B-mode ultrasound for anatomical visualization and Doppler ultrasound for blood flow assessment.

2. Anatomy Visualization:

  • B-mode ultrasound is used to visualize the superficial and deep veins of the legs, including the great saphenous vein (GSV), small saphenous vein (SSV), femoral vein, popliteal vein, and calf veins.
  • Anatomical abnormalities such as varicose veins, venous dilation, or venous malformations can be identified on ultrasound imaging.

3. Blood Flow Assessment:

  • Doppler ultrasound is employed to assess blood flow within the veins and detect abnormalities such as venous reflux and obstruction.
  • Venous reflux refers to the backward flow of blood in the veins due to valve incompetence. It can lead to venous insufficiency, characterized by swelling, pain, and skin changes.
  • Color Doppler ultrasound provides additional information about blood flow direction and velocity, aiding in the detection of venous reflux and assessment of venous patency.

4. Evaluation of Swelling:

  • Ultrasound imaging can help identify the underlying cause of leg swelling, which may be related to venous insufficiency, deep vein thrombosis (DVT), or lymphatic obstruction.
  • Venous insufficiency may result in chronic swelling of the legs due to impaired venous return and fluid accumulation in the tissues.
  • Ultrasound can assess the patency and competence of the venous system and identify any obstructions or abnormalities contributing to swelling.

5. Differential Diagnosis:

  • Ultrasound imaging aids in the differential diagnosis of leg swelling by distinguishing between venous, arterial, and lymphatic causes.
  • In addition to venous insufficiency, ultrasound can detect other vascular disorders such as DVT, peripheral artery disease (PAD), and lymphedema.

6. Clinical Applications:

  • Venous duplex ultrasound is used in the diagnosis and management of various venous disorders, including chronic venous insufficiency, varicose veins, venous thrombosis (DVT), and venous ulcers.
  • It helps guide treatment decisions, such as compression therapy, endovenous ablation procedures, or anticoagulant therapy, based on the underlying venous pathology identified on imaging.

In summary, venous insufficiency and swelling can be evaluated using ultrasound imaging techniques, which provide detailed information about the anatomy and hemodynamics of the venous system of the lower extremities. This imaging modality plays a crucial role in the diagnosis and management of venous disorders affecting the legs.

In the context of ultrasound and medical imaging, “visceral” refers to structures and organs located within the body’s cavities, particularly the thoracic (chest) and abdominal cavities. Visceral organs are those that are contained within these cavities and perform vital functions related to digestion, respiration, circulation, and reproduction. Ultrasound and imaging techniques are commonly used to visualize and assess these visceral organs for diagnostic purposes. Here’s an overview of the visceral organs commonly evaluated using ultrasound and imaging:

1. Abdominal Visceral Organs:

  • Liver: Ultrasound is frequently used to assess the size, shape, texture, and vascularity of the liver, as well as to detect abnormalities such as masses, cysts, or fatty infiltration.
  • Gallbladder: Ultrasound can visualize the gallbladder and assess for the presence of gallstones, inflammation (cholecystitis), or gallbladder wall thickening.
  • Pancreas: Imaging techniques can visualize the pancreas and evaluate for abnormalities such as pancreatic cysts, tumors, or inflammation (pancreatitis).
  • Spleen: Ultrasound can assess the size, shape, and texture of the spleen, as well as detect abnormalities such as splenomegaly (enlargement) or focal lesions.
  • Kidneys: Renal ultrasound is used to evaluate the size, shape, position, and structure of the kidneys, as well as detect renal masses, cysts, or hydronephrosis.
  • Adrenal glands: Imaging techniques can visualize the adrenal glands and assess for adrenal masses or abnormalities such as adrenal adenomas or hyperplasia.

2. Thoracic Visceral Organs:

  • Heart: Echocardiography is a specialized ultrasound technique used to assess the structure and function of the heart, including the chambers, valves, and myocardium.
  • Lungs: Chest X-rays and computed tomography (CT) scans are commonly used to evaluate the lungs for abnormalities such as pneumonia, lung nodules, or pleural effusions.
  • Mediastinum: Imaging techniques can visualize the mediastinal structures, including the thymus, lymph nodes, and great vessels, and assess for abnormalities such as masses or lymphadenopathy.

3. Pelvic Visceral Organs:

  • Uterus and ovaries: Transabdominal and transvaginal ultrasound are used to assess the uterus and ovaries in women for abnormalities such as fibroids, ovarian cysts, or gynecological malignancies.
  • Prostate: Transrectal ultrasound is used to evaluate the prostate gland in men for abnormalities such as prostate enlargement (benign prostatic hyperplasia) or prostate cancer.

In summary, visceral organs are vital structures located within the body’s cavities, including the abdomen, thorax, and pelvis. Ultrasound and imaging techniques are valuable tools for visualizing and assessing these organs for diagnostic purposes, aiding in the detection and management of various medical conditions and diseases.

Abdominal aorta ultrasound

Abdominal aorta screening ultrasound is a diagnostic imaging technique used to examine the abdominal aorta, the largest artery in the abdominal cavity, for potential abnormalities, primarily abdominal aortic aneurysms (AAA). It is a non-invasive procedure that utilizes high-frequency sound waves (ultrasound) to create real-time images of the abdominal aorta and surrounding structures.

During the ultrasound examination, a trained technician, often called a sonographer, places a gel on the abdomen to facilitate the transmission of sound waves. They then use a handheld device called a transducer, which emits sound waves and receives the echoes bouncing back from the tissues inside the body. These echoes are processed by a computer to generate detailed images of the abdominal aorta on a monitor.

The purpose of abdominal aorta screening ultrasound is to detect any abnormal widening or bulging of the abdominal aorta, which could indicate the presence of an AAA. AAAs are a serious medical condition characterized by the weakening and dilation of the abdominal aortic wall. If left untreated, AAAs can rupture, leading to life-threatening internal bleeding.

Screening ultrasounds are typically recommended for individuals at higher risk of developing AAA, such as older adults, especially men over 65 years old, individuals with a history of smoking, hypertension, or a family history of AAA. However, screening recommendations may vary depending on the guidelines of different healthcare organizations.

Abdominal aorta screening ultrasound is an important tool in preventive medicine because it allows for the early detection of AAAs, enabling healthcare providers to implement appropriate interventions, such as surveillance, lifestyle modifications, or surgical repair, to prevent rupture and its potentially fatal consequences. Early detection and management of AAAs can significantly improve patient outcomes and reduce mortality rates associated with this condition.

Ankle/brachial Indices (ABI) ultrasound

Ankle-Brachial Indices (ABI) ultrasound is a diagnostic test used to evaluate peripheral arterial disease (PAD), a condition characterized by narrowing or blockage of the arteries in the limbs, particularly the legs. The ABI test compares blood pressure measurements taken at the ankle with those taken at the arm (brachial artery) to assess the blood flow in the lower extremities relative to that in the upper extremities.

Here’s how the ABI ultrasound procedure typically works:

  1. Preparation: The patient lies down comfortably on an examination table. Blood pressure cuffs are placed around both arms and both ankles.
  2. Blood Pressure Measurement: A healthcare provider or technician uses a handheld Doppler ultrasound device to detect blood flow in the arteries of the arms and ankles. They place the Doppler probe over the brachial artery in the arm and then over the posterior tibial artery and dorsalis pedis artery in each ankle.
  3. Blood Pressure Recording: Blood pressure measurements are taken at each location using the Doppler probe and a blood pressure cuff. The systolic blood pressure is recorded at each site.
  4. Calculation of ABI: The ankle systolic blood pressure is divided by the higher of the two brachial systolic blood pressures to calculate the ABI for each leg. The ABI is calculated separately for each leg.

The normal ABI value typically falls between 0.90 and 1.30. An ABI below 0.90 is generally considered indicative of PAD, with lower values indicating more severe disease. An ABI above 1.30 may suggest non-compressible arteries, often seen in individuals with diabetes or calcified arteries.

ABI ultrasound is valuable for diagnosing PAD, assessing disease severity, and guiding treatment decisions. It helps healthcare providers evaluate the risk of complications such as leg ulcers, gangrene, and amputation, and it assists in developing personalized management plans for patients with PAD. Additionally, ABI testing is non-invasive, relatively quick, and well-tolerated by patients, making it a widely used diagnostic tool in vascular medicine.

Aorta iliac ultrasound

Aorta iliac ultrasound, also known as abdominal aorta and iliac artery ultrasound, is a diagnostic imaging procedure used to assess the abdominal aorta and its branches, particularly the iliac arteries. This non-invasive test utilizes high-frequency sound waves (ultrasound) to produce real-time images of the blood vessels in the abdomen and pelvis.

Aorta iliac ultrasound is commonly used for various clinical purposes, including:

  • Screening for abdominal aortic aneurysms (AAA) in asymptomatic individuals, particularly those at higher risk (e.g., older adults, smokers, individuals with a family history of AAA).
  • Diagnosing and monitoring vascular diseases affecting the abdominal aorta and iliac arteries, such as atherosclerosis, thrombosis, or dissection.
  • Planning and guiding interventions or surgeries, such as endovascular repair of aortic aneurysms or angioplasty for iliac artery stenosis.

Overall, aorta iliac ultrasound is a valuable tool in vascular medicine, providing important diagnostic information that guides patient management and treatment decisions while being safe, non-invasive, and well-tolerated by patients.

Arterial duplex ultrasound – legs

Arterial duplex ultrasound of the legs is a non-invasive diagnostic imaging test used to evaluate the blood flow and anatomy of the arteries in the lower extremities. It combines two types of ultrasound techniques: Doppler ultrasound and B-mode ultrasound (also known as duplex ultrasound), hence the term “duplex.”

Here’s an overview of the procedure:

  1. Preparation: The patient typically lies down on an examination table, and the area to be examined (usually the legs) is exposed. There is usually no specific preparation required for this test, although it’s advisable to wear loose-fitting clothing that can be easily rolled up or removed if necessary.
  2. Application of Gel: A clear, water-based gel is applied to the skin over the legs. This gel helps to facilitate the transmission of sound waves and ensures good contact between the skin and the ultrasound transducer.
  3. Ultrasound Examination: A trained ultrasound technician (sonographer) or healthcare provider uses a handheld ultrasound probe called a transducer to capture images of the blood vessels in the legs. The transducer emits high-frequency sound waves that penetrate through the skin and bounce back (echo) when they encounter blood flowing within the arteries. The Doppler effect is used to detect the speed and direction of blood flow, while the B-mode ultrasound provides real-time images of the artery walls and surrounding tissues.
  4. Image Acquisition: The technician or healthcare provider moves the transducer along the surface of the skin, systematically scanning the arteries in the legs from various angles. They assess the size, shape, and blood flow characteristics of the arteries, looking for any abnormalities such as narrowing (stenosis), blockages (occlusions), or plaques (atherosclerosis).
  5. Interpretation: The ultrasound images and Doppler waveforms are analyzed to evaluate the blood flow patterns, detect any abnormalities, and assess the severity of vascular disease. The findings are interpreted by a radiologist or vascular specialist, who provides a report to the referring healthcare provider.

Arterial duplex ultrasound of the legs is a valuable tool in vascular medicine, providing important diagnostic information that guides patient management and treatment decisions. It is safe, non-invasive, and well-tolerated by patients.

Carotid duplex ultrasound

Carotid duplex ultrasound is a sophisticated diagnostic tool used to evaluate the carotid arteries, vital blood vessels in the neck that supply oxygen-rich blood to the brain. This non-invasive imaging procedure combines B-mode ultrasound and Doppler ultrasound techniques to provide detailed information about the structure and function of the carotid arteries. In this comprehensive guide, we will explore the purpose, procedure, significance, and potential findings of carotid duplex ultrasound.

The primary purpose of carotid duplex ultrasound is to assess the presence and severity of carotid artery disease, including atherosclerosis and stenosis. By evaluating the structure of the artery walls, detecting the presence of plaque buildup, and measuring blood flow velocity, carotid duplex ultrasound helps healthcare providers identify individuals at risk for stroke or transient ischemic attack (TIA). Additionally, it plays a crucial role in guiding treatment decisions and interventions aimed at reducing the risk of stroke.

During a carotid duplex ultrasound examination, the patient typically lies comfortably on an examination table in a slightly reclined position. A clear, water-based gel is applied to the skin over the neck area where the carotid arteries are located to facilitate sound wave transmission. A trained ultrasound technician or healthcare provider then uses a handheld ultrasound transducer to capture images and Doppler waveforms of the carotid arteries. The examination involves systematically scanning both sides of the neck to assess the size, shape, and integrity of the artery walls, as well as the presence of any plaques or areas of stenosis. Doppler measurements are taken to evaluate blood flow velocity and detect abnormalities in blood flow patterns.

Carotid duplex ultrasound is a valuable diagnostic tool in vascular medicine, providing essential information for the assessment and management of carotid artery disease. Through early detection, risk stratification, and guided interventions, carotid duplex ultrasound plays a crucial role in reducing the burden of stroke and improving patient outcomes. Healthcare providers should consider incorporating carotid duplex ultrasound into routine clinical practice, particularly for individuals at risk for cerebrovascular events.

Saphenous vein mapping ultrasound

Saphenous vein mapping ultrasound is a diagnostic procedure used to assess the anatomy and patency of the saphenous veins in the lower extremities. It is commonly performed prior to vein harvesting for surgical procedures such as coronary artery bypass grafting (CABG) or peripheral vascular bypass surgery. Here’s a step-by-step guide on how to perform a saphenous vein mapping ultrasound:

  1. Patient Preparation:
    • Explain the procedure to the patient and obtain informed consent.
    • Ensure the patient is lying comfortably on the examination table in a supine position.
    • Expose the lower extremities, particularly the thigh and calf regions, where the saphenous veins are located.
  2. Equipment Setup:
    • Use a high-frequency ultrasound probe suitable for vascular imaging.
    • Ensure the ultrasound machine is properly calibrated and set to the appropriate settings for vascular imaging.
  3. Probe Placement:
    • Begin by identifying the saphenous vein at its proximal origin in the groin region. The greater saphenous vein (GSV) typically originates from the saphenofemoral junction (SFJ), while the lesser saphenous vein (LSV) originates from the popliteal vein.
    • Place the ultrasound probe transversely or longitudinally over the groin area to visualize the SFJ and the proximal segment of the GSV.
    • Apply gentle pressure with the probe to compress the vein and confirm its compressibility, which is a characteristic feature of veins on ultrasound imaging.
  4. Scanning Technique:
    • Slowly move the ultrasound probe distally along the course of the saphenous vein, tracing its path through the thigh and calf regions.
    • Use both transverse and longitudinal scanning planes to visualize the entire length of the saphenous vein, including any tributaries or branches.
    • Rotate and tilt the ultrasound probe as needed to obtain optimal imaging views of the saphenous vein and surrounding structures.
    • Use color Doppler ultrasound to assess blood flow within the saphenous vein and detect any areas of stenosis, thrombosis, or abnormal flow patterns.
  5. Documentation:
    • Record images and video clips of the saphenous vein mapping procedure, documenting the anatomy, size, and patency of the vein.
    • Measure the diameter of the saphenous vein at various locations along its course, including the SFJ, mid-thigh, knee, and calf regions.
    • Document any abnormalities or findings suggestive of venous insufficiency, such as reflux or venous wall thickening.
  6. Interpretation and Reporting:
    • The ultrasound findings are interpreted by a radiologist or vascular specialist, who assesses the anatomy, patency, and suitability of the saphenous vein for surgical harvesting.
    • A comprehensive report is generated, detailing the findings of the saphenous vein mapping ultrasound and providing recommendations for further management or surgical planning.
  7. Clinical Applications:
    • Saphenous vein mapping ultrasound is used to identify suitable segments of the saphenous vein for harvesting in vascular surgical procedures such as CABG or peripheral vascular bypass surgery.
    • It helps guide surgical planning and decision-making, ensuring the selection of high-quality veins with adequate diameter and patency for grafting purposes.

In summary, saphenous vein mapping ultrasound is a valuable tool in vascular surgery, providing detailed anatomical and hemodynamic information about the saphenous veins in the lower extremities. By accurately assessing vein morphology and patency, it helps optimize surgical outcomes and minimize complications in patients undergoing vascular procedures.

Standing Venous duplex ultrasound – legs

Venous duplex ultrasound of the legs is a non-invasive diagnostic imaging procedure used to evaluate the venous system of the lower extremities. This imaging technique combines B-mode ultrasound and Doppler ultrasound to visualize the anatomy of the leg veins and assess blood flow characteristics. Here’s an overview of venous duplex ultrasound of the legs:

1. Patient Preparation:

  • The patient is typically instructed to wear loose-fitting clothing to facilitate access to the legs.
  • No special preparation, such as fasting, is usually required before the procedure.

2. Equipment Setup:

  • A high-frequency ultrasound transducer is used for imaging the superficial and deep veins of the legs.
  • The ultrasound machine is equipped with both B-mode and Doppler capabilities for anatomical visualization and blood flow assessment.

3. Imaging Protocol:

  • The ultrasound technologist or healthcare provider applies ultrasound gel to the skin overlying the legs to facilitate sound wave transmission and minimize air interference.
  • The transducer is then placed sequentially along the course of the leg veins, including the common femoral vein, femoral vein, popliteal vein, and calf veins.
  • B-mode ultrasound is used to visualize the veins, identify any abnormalities such as thrombus or venous dilation (varicose veins), and measure vein diameter.
  • Doppler ultrasound is employed to assess blood flow within the veins, detect venous reflux (backward flow), and measure blood flow velocities.
  • Color Doppler ultrasound may be used to provide additional information about blood flow direction and velocity, particularly in cases of venous insufficiency or deep vein thrombosis (DVT).

4. Evaluation:

  • The ultrasound examination evaluates several key parameters, including:
    • Anatomy of the leg veins: Assessing for the presence of varicose veins, venous dilation, or venous malformations.
    • Venous patency: Detecting any obstruction or narrowing of the veins that may impede blood flow.
    • Venous reflux: Assessing for the presence and severity of venous valve incompetence, which can lead to venous insufficiency and chronic venous disease.
    • Thrombus detection: Identifying the presence of acute or chronic thrombus (blood clot) within the veins, which may indicate deep vein thrombosis (DVT).

5. Interpretation and Reporting:

  • The ultrasound findings are interpreted by a radiologist or vascular specialist.
  • A comprehensive report is generated, documenting the status of the leg veins, any detected abnormalities or pathology, and recommendations for further management or intervention.

6. Clinical Applications:

  • Venous duplex ultrasound of the legs is used in the diagnosis and management of various venous disorders, including chronic venous insufficiency, varicose veins, venous thrombosis (DVT), and venous ulcers.
  • It helps guide treatment decisions, such as compression therapy, endovenous ablation procedures, or anticoagulant therapy, based on the underlying venous pathology identified on imaging.

Upper extremity DVT

Upper extremity deep vein thrombosis (DVT) refers to the formation of blood clots within the veins of the arms, including the axillary, brachial, radial, and ulnar veins. While DVT commonly occurs in the lower extremities, particularly the deep veins of the legs, it can also affect the upper extremities, though less frequently. Upper extremity DVT can lead to significant morbidity and complications if left untreated. Here’s an overview of upper extremity DVT:

Causes:

  1. Venous Stasis: Reduced blood flow within the upper extremity veins can occur due to various factors such as immobility, prolonged sitting or standing, or conditions that impede venous return.
  2. Vascular Injury: Trauma to the veins, such as catheter insertion, surgery, or direct injury, can predispose to the formation of blood clots.
  3. Hypercoagulable States: Certain medical conditions or risk factors can increase the risk of blood clot formation, including inherited thrombophilias, malignancy, hormonal therapy (e.g., estrogen-containing contraceptives), or systemic inflammatory disorders.

Symptoms:

  1. Arm Swelling: Swelling of the affected arm, often accompanied by pain or discomfort, is a common symptom of upper extremity DVT.
  2. Arm Pain: Patients may experience pain or tenderness along the course of the affected veins, which may worsen with movement or palpation.
  3. Warmth and Redness: The skin overlying the affected area may feel warm to the touch and appear red or discolored due to inflammation.
  4. Visible Veins: In some cases, dilated or engorged veins may be visible on the surface of the skin, particularly in the area where the clot is located.

Complications:

  1. Pulmonary Embolism: A blood clot in the upper extremity veins can dislodge and travel through the bloodstream to the lungs, causing a potentially life-threatening pulmonary embolism.
  2. Post-Thrombotic Syndrome: Chronic venous insufficiency and persistent symptoms such as pain, swelling, and skin changes may occur in some patients following resolution of the acute thrombotic event.
  3. Recurrent Thrombosis: Individuals with upper extremity DVT may be at increased risk of recurrent thrombosis, particularly if underlying risk factors are not adequately addressed or managed.

Diagnosis:

  1. Ultrasound Imaging: Duplex ultrasound of the upper extremity veins is the primary diagnostic modality for detecting and confirming the presence of DVT. It allows visualization of the veins and identification of intraluminal blood clots.
  2. Venography: In some cases, venography may be performed to provide detailed imaging of the upper extremity veins and assess the extent of thrombus involvement, particularly in complex or recurrent cases.

Treatment:

  1. Anticoagulation: The mainstay of treatment for upper extremity DVT is anticoagulant therapy to prevent clot propagation and reduce the risk of complications such as pulmonary embolism.
  2. Thrombolysis: In select cases of extensive or symptomatic upper extremity DVT, thrombolytic therapy may be considered to dissolve the clot and restore venous patency.
  3. Vascular Interventions: Endovascular procedures such as catheter-directed thrombolysis or mechanical thrombectomy may be employed in cases of severe or refractory upper extremity DVT to remove the clot and restore venous flow.

In summary, upper extremity DVT is a potentially serious condition characterized by the formation of blood clots within the veins of the arms. Prompt diagnosis and appropriate treatment are essential to prevent complications and optimize outcomes in affected individuals.

Upper extremity vein mapping

  • Upper extremity vein mapping

Varicose vein surgery pre-op survey

A pre-operative survey using ultrasound for varicose vein surgery involves the use of ultrasound imaging to assess the anatomy and hemodynamics of the veins affected by varicose veins before undergoing surgical intervention. This survey helps the healthcare team plan the surgical approach, determine the extent of venous reflux or obstruction, and identify any underlying venous pathology that may impact the surgical outcome. Here’s an overview of the pre-operative survey process:

1. Patient Evaluation:

  • The patient’s medical history, symptoms, and risk factors for venous insufficiency or varicose veins are assessed.
  • A physical examination of the lower extremities is performed to evaluate the extent of varicose veins, skin changes, and signs of venous insufficiency.

2. Ultrasound Imaging:

  • Duplex ultrasound imaging is the primary modality used for the pre-operative survey of varicose veins.
  • Ultrasound allows for real-time visualization of the superficial and deep veins, assessment of venous reflux, identification of incompetent perforator veins, and detection of any associated venous thrombosis or obstruction.
  • Color Doppler ultrasound is used to assess blood flow direction and velocity within the veins, while B-mode ultrasound provides detailed anatomical information about vein size, wall morphology, and presence of thrombus.

3. Venous Mapping:

  • The ultrasound technician or vascular specialist performs a systematic evaluation of the lower extremity veins, including the great saphenous vein, small saphenous vein, perforator veins, and tributary veins.
  • Vein mapping involves measuring vein diameter, assessing for reflux or retrograde flow, and identifying sites of venous insufficiency or incompetence.
  • Venous mapping helps guide the selection of appropriate treatment options, such as endovenous ablation, sclerotherapy, or surgical vein ligation and stripping.

4. Assessment of Venous Anatomy:

  • Ultrasound imaging helps assess the anatomical variation of the venous system, such as the presence of duplicated or accessory veins, venous tributaries, and venous anomalies.
  • Understanding the venous anatomy is essential for planning the surgical approach and ensuring complete treatment of varicose veins while minimizing the risk of complications.

5. Documentation and Surgical Planning:

  • The findings of the pre-operative survey are documented in a comprehensive report, which includes details about vein anatomy, reflux patterns, presence of thrombus or obstruction, and any associated venous pathology.
  • Based on the ultrasound findings, the surgical team develops a tailored treatment plan for varicose vein surgery, selecting the most appropriate techniques and interventions to address the patient’s specific venous pathology and clinical needs.

In summary, a pre-operative survey using ultrasound for varicose vein surgery plays a crucial role in evaluating venous anatomy, identifying pathological changes, and guiding surgical planning to achieve optimal outcomes for patients with varicose veins.

Varicose vein surgery post-op evaluation

Performing a post-operative evaluation of varicose vein surgery using ultrasound can provide valuable insights into the surgical outcomes, assess for any residual venous abnormalities, and detect potential complications. Here’s how ultrasound can be utilized in the post-operative evaluation:

1. Assessment of Surgical Sites:

  • Ultrasound imaging is used to visualize the surgical sites and evaluate the integrity of the treated veins, including the great saphenous vein (GSV) or small saphenous vein (SSV) if they were targeted during the surgery.
  • The presence of residual varicosities, venous reflux, or incomplete vein closure (in cases of endovenous ablation procedures) can be assessed.

2. Detection of Hematomas or Fluid Collections:

  • Ultrasound can detect the presence of hematomas or seromas at the surgical sites, which may indicate post-operative bleeding or fluid accumulation.
  • Color Doppler imaging can help differentiate between vascular and non-vascular fluid collections.

3. Evaluation of Venous Flow and Patency:

  • Duplex ultrasound is utilized to assess venous flow patterns and detect any abnormalities such as venous obstruction, thrombosis, or residual reflux.
  • Venous patency is assessed by visualizing the flow within the treated veins and assessing for any flow disturbances or stenosis.

4. Identification of Complications:

  • Ultrasound can help identify complications such as deep vein thrombosis (DVT), superficial thrombophlebitis, or venous injury that may occur as a result of the surgical procedure.
  • Compression ultrasound may be performed to assess for the presence of compressible veins and rule out DVT in patients with suspected symptoms or risk factors.

5. Comparison with Pre-operative Findings:

  • Post-operative ultrasound findings are compared with pre-operative imaging studies to evaluate the effectiveness of the surgical intervention and assess for any changes in venous anatomy or hemodynamics.
  • Any discrepancies between pre-operative and post-operative findings are noted and may prompt further evaluation or intervention.

6. Follow-up Monitoring:

  • Follow-up ultrasound examinations may be scheduled at regular intervals to monitor the progress of healing, assess for resolution of any residual venous abnormalities, and ensure long-term success of the surgical treatment.
  • Patient symptoms and clinical findings are correlated with ultrasound findings to guide ongoing management and optimize patient outcomes.

In summary, ultrasound imaging plays a crucial role in the post-operative evaluation of varicose vein surgery, providing detailed assessment of the surgical outcomes, detection of complications, and guidance for further management as needed.

Venous insufficiency/swelling

Venous insufficiency and swelling can be assessed using ultrasound imaging techniques, particularly venous duplex ultrasound, which combines B-mode ultrasound and Doppler ultrasound to visualize the anatomy of the veins and assess blood flow characteristics. Here’s how venous insufficiency and swelling are evaluated using ultrasound imaging:

1. Venous Duplex Ultrasound:

  • Venous duplex ultrasound is a non-invasive imaging modality used to evaluate the venous system of the lower extremities.
  • It combines two modes of ultrasound imaging: B-mode ultrasound for anatomical visualization and Doppler ultrasound for blood flow assessment.

2. Anatomy Visualization:

  • B-mode ultrasound is used to visualize the superficial and deep veins of the legs, including the great saphenous vein (GSV), small saphenous vein (SSV), femoral vein, popliteal vein, and calf veins.
  • Anatomical abnormalities such as varicose veins, venous dilation, or venous malformations can be identified on ultrasound imaging.

3. Blood Flow Assessment:

  • Doppler ultrasound is employed to assess blood flow within the veins and detect abnormalities such as venous reflux and obstruction.
  • Venous reflux refers to the backward flow of blood in the veins due to valve incompetence. It can lead to venous insufficiency, characterized by swelling, pain, and skin changes.
  • Color Doppler ultrasound provides additional information about blood flow direction and velocity, aiding in the detection of venous reflux and assessment of venous patency.

4. Evaluation of Swelling:

  • Ultrasound imaging can help identify the underlying cause of leg swelling, which may be related to venous insufficiency, deep vein thrombosis (DVT), or lymphatic obstruction.
  • Venous insufficiency may result in chronic swelling of the legs due to impaired venous return and fluid accumulation in the tissues.
  • Ultrasound can assess the patency and competence of the venous system and identify any obstructions or abnormalities contributing to swelling.

5. Differential Diagnosis:

  • Ultrasound imaging aids in the differential diagnosis of leg swelling by distinguishing between venous, arterial, and lymphatic causes.
  • In addition to venous insufficiency, ultrasound can detect other vascular disorders such as DVT, peripheral artery disease (PAD), and lymphedema.

6. Clinical Applications:

  • Venous duplex ultrasound is used in the diagnosis and management of various venous disorders, including chronic venous insufficiency, varicose veins, venous thrombosis (DVT), and venous ulcers.
  • It helps guide treatment decisions, such as compression therapy, endovenous ablation procedures, or anticoagulant therapy, based on the underlying venous pathology identified on imaging.

In summary, venous insufficiency and swelling can be evaluated using ultrasound imaging techniques, which provide detailed information about the anatomy and hemodynamics of the venous system of the lower extremities. This imaging modality plays a crucial role in the diagnosis and management of venous disorders affecting the legs.

Visceral

In the context of ultrasound and medical imaging, “visceral” refers to structures and organs located within the body’s cavities, particularly the thoracic (chest) and abdominal cavities. Visceral organs are those that are contained within these cavities and perform vital functions related to digestion, respiration, circulation, and reproduction. Ultrasound and imaging techniques are commonly used to visualize and assess these visceral organs for diagnostic purposes. Here’s an overview of the visceral organs commonly evaluated using ultrasound and imaging:

1. Abdominal Visceral Organs:

  • Liver: Ultrasound is frequently used to assess the size, shape, texture, and vascularity of the liver, as well as to detect abnormalities such as masses, cysts, or fatty infiltration.
  • Gallbladder: Ultrasound can visualize the gallbladder and assess for the presence of gallstones, inflammation (cholecystitis), or gallbladder wall thickening.
  • Pancreas: Imaging techniques can visualize the pancreas and evaluate for abnormalities such as pancreatic cysts, tumors, or inflammation (pancreatitis).
  • Spleen: Ultrasound can assess the size, shape, and texture of the spleen, as well as detect abnormalities such as splenomegaly (enlargement) or focal lesions.
  • Kidneys: Renal ultrasound is used to evaluate the size, shape, position, and structure of the kidneys, as well as detect renal masses, cysts, or hydronephrosis.
  • Adrenal glands: Imaging techniques can visualize the adrenal glands and assess for adrenal masses or abnormalities such as adrenal adenomas or hyperplasia.

2. Thoracic Visceral Organs:

  • Heart: Echocardiography is a specialized ultrasound technique used to assess the structure and function of the heart, including the chambers, valves, and myocardium.
  • Lungs: Chest X-rays and computed tomography (CT) scans are commonly used to evaluate the lungs for abnormalities such as pneumonia, lung nodules, or pleural effusions.
  • Mediastinum: Imaging techniques can visualize the mediastinal structures, including the thymus, lymph nodes, and great vessels, and assess for abnormalities such as masses or lymphadenopathy.

3. Pelvic Visceral Organs:

  • Uterus and ovaries: Transabdominal and transvaginal ultrasound are used to assess the uterus and ovaries in women for abnormalities such as fibroids, ovarian cysts, or gynecological malignancies.
  • Prostate: Transrectal ultrasound is used to evaluate the prostate gland in men for abnormalities such as prostate enlargement (benign prostatic hyperplasia) or prostate cancer.

In summary, visceral organs are vital structures located within the body’s cavities, including the abdomen, thorax, and pelvis. Ultrasound and imaging techniques are valuable tools for visualizing and assessing these organs for diagnostic purposes, aiding in the detection and management of various medical conditions and diseases.

We offer the following screenings (non exhaustive) to examine various areas of the body:

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Three Convenient Locations

voorhees

Voorhees Office

1101 White Horse Rd Suite C Voorhees, NJ 08043
vineland

Vineland Office

1138 E. Chestnut Ave, Suite 8A, Vineland, NJ 08360

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Sewell Office

556 Egg Harbor Rd Suite A Sewell, NJ 08080

FAQs

When you arrive for your appointment, one of our ultrasound technologists will greet you and review the study with you. Afterward, you will be asked to lie down on a table where the area to be examined is exposed. A warm, clear gel will be applied to the area. Then, a small device called a transducer will pass over the gel and begin capturing images.

Once the study is complete, the gel will be wiped off and any portions that are not removed will dry to a powder. The gel will not stain or alter clothing.

An ultrasound requires very minimal preparation. Based on the specific area being studied, your doctor and our team of imaging experts at South Jersey Radiology will provide specific guidelines to follow before your study. Here are some general guidelines to follow:

  • Arrive 15 minutes prior to your appointment.
  • For an ultrasound of the liver, gallbladder, spleen, or pancreas, eat a low-fat dinner on the day before the exam and do not eat or drink for at least twelve hours prior to your appointment.
  • For an ultrasound of your pelvis, you will need to have a full bladder. Please drink 6 eight-ounce glasses of water. Finish drinking this amount of liquid one hour prior to your appointment. Do not use the bathroom before your exam.
  • For an ultrasound of your kidneys, you may be asked to drink 4 to 6 glasses of water one hour prior to your appointment.
  • For an ultrasound of your aorta, please refrain from eating for at least 8 hours prior to your appointment.

An ultrasound is a painless and non-invasive imaging technique that uses no forms of radiation.

After your ultrasound appointment, a radiologists will analyze the results and develop a detailed report for your doctor. Your doctor will receive the report within 48 hours and follow up with you to go over the results.

Ultrasound can be used to diagnose a wide range of conditions, including pregnancy-related issues, abnormalities in organs such as the liver, kidneys, and gallbladder, as well as conditions affecting the heart, blood vessels, and musculoskeletal system.

It depends on the specific instructions provided by your healthcare provider. For some ultrasound exams, such as abdominal ultrasounds, fasting for several hours may be required. However, for other exams, there may be no specific dietary restrictions.

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Ultrasound is generally considered safe with no known risks or side effects when performed by trained professionals. However, excessive or prolonged exposure to ultrasound energy should be avoided, especially during pregnancy, unless medically necessary.

Ultrasound can help detect certain types of cancer by imaging abnormal masses or tumors in various organs. However, it may not be as sensitive as other imaging techniques like MRI or CT scans for detecting all types of cancer.

While ultrasound is a valuable imaging tool, it may have limitations in visualizing certain structures, such as those obscured by gas or bone. Additionally, it may not provide detailed information about tissue characteristics compared to other imaging modalities like MRI or CT scans.

The duration of an ultrasound exam depends on the area of the body being examined and the complexity of the study. Some ultrasound exams may take only a few minutes, while others may take longer, especially if multiple areas are being evaluated.

In many cases, a referral from a healthcare provider, such as a primary care physician or a specialist, is required to undergo an ultrasound examination. Your healthcare provider will determine if an ultrasound is necessary based on your medical history and symptoms.

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