Written by Angela Mills, BA, RVS

What’s wrong with this vascular image?

What’s wrong with this vascular image?

Modality: Carotid Duplex
View: Long axis CCA

Answer:

This image demonstrates prox CCA that was labeled and measured as a distal CCA.

Correct Technique:

  • The Proximal CCA placement should be very low on the neck usually close to the collar bone
  • The Distal should be no more than 1-2 cm from the bifurcation.

carotid duplexcase studyCCAultrasoundvascular

LET US KNOW WHAT YOU THINK...

Jennie
One should always demonstrate the bulb when taking a Doppler sample of distal CCA. You can also see that the spectral Doppler is displaying a high resistance waveform, which is typical of a proximal CCA. Flow here in the Carotid has not had time to turn into a low resistance state, as it is too close to the heart. Not until further distal does it change to lower resistance, as it then is converting to feed a low resistance bed, the brain. If this was truly a distal CCA waveform, demonstrating such high resistance, one should be concerned about a significant ICA stenosis. Key to remember in vascular: Systole tells you if there is a proximal problem; Diastole tells you if a distal problem exists.
Cardioserv
Thank you for that valuable input!
jose donis
very nice case thank you
Fona
Anything can cause proximal to proximal CCA stenosis, like Aortic stenosis, will cause this wave form.
Gloria Bustillo
it's very nice case and if could provide more. Thanks

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