Abstract

ObjectiveTo investigate the value of Vector Flow Imaging (V Flow) in the assessment of post-stenotic turbulence in the canine arterial stenosis model.Materials and MethodsCanine femoral artery stenosis models were established using ameroid constrictors in 12 beagle dogs. 50% and then 70% femoral artery stenoses were confirmed by selective femoral artery angiography. V Flow was used to measure femoral artery flow turbulence index (Tur) preoperatively as a baseline. After establishing of a 50% and then 70% stenoses, the Tur indices were recorded in the femoral artery at 1, 3, 5, 7, 9, 11, 13, 15, 17, and 19 mm distal to the stenosis.ResultsBaseline Tur indices of normal canine femoral arteries were <1% in 11 of 12 cases (91.7%). Distal to a 50% stenosis, the Tur index (>1%) was recorded in 83.3–100% cases between 1 and 9 mm, 41.7–58.3% between 11 and 17 mm, and 16.7% at 19 mm. For a 70% stenosis, the Tur index (>1%) occurred in 81.8–100% cases between 1 and 17 mm distal to the stenosis, and 63.6% at 19 mm. The Tur index peaked around 7 mm or 2.3 times of the initial vessel diameter (3 mm) downstream for a 50% stenosis and 11 mm or 3.7 times of vessel diameter downstream for a 70% stenosis.ConclusionV Flow with Tur index measurement adds quantitative information of post-stenotic turbulence when assessing an arterial stenosis with ultrasound. Tur index of 1% seems a useful threshold for assessment of flow turbulence in this small sample study. Further studies with larger sample size are needed to evaluate the value of V Flow in clinical applications.

Highlights

  • Arterial stenosis/occlusion is a common vascular pathology and most commonly caused by atherosclerosis [1, 2]

  • The aim of this study is to explore the value of vector flow imaging (V Flow) in the evaluation of post-stenotic turbulence in the canine arterial stenosis model

  • Based on a canine femoral artery diameter of 3 mm, post-stenotic turbulence index (Tur) index increased immediately distal to the stenosis and reached its maximum value at 5–11 mm or 1.7– 3.7 diameters downstream in 9 of 12 cases (75%) with most at 7 mm or 2.3 times the vessel diameter downstream (5/12)

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Summary

Introduction

Arterial stenosis/occlusion is a common vascular pathology and most commonly caused by atherosclerosis [1, 2]. Other causes of this condition include Takayasu’s disease, Burger’s disease (thromboangiitis obliterans), fibromuscular dysplasia, adventitial cystic disease of the popliteal artery, popliteal artery entrapment, endofibrosis of the external iliac artery (iliac artery syndrome in cyclists), thoracic outlet syndrome, etc. Duplex ultrasound assessment of arterial stenosis includes observation of intraluminal plaque, measurement of velocities and evaluation of post-stenotic turbulence, as well as the profile of the waveform [7]. Flow turbulence is qualitatively assessed by the appearance of multiple colors on the color Doppler image and spectral broadening on the spectral Doppler waveform. Most published studies using V Flow have been investigations on carotid arteries for blood flow visualization, wall shear stress measurement and volume flow estimation, as well as in the assessment of arterial stenosis before and after carotid artery stenting [13,14,15,16,17,18,19,20,21]

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