The vascular lab (VL) is instrumental in diagnosing vascular diseases such as renal
artery stenosis and mesenteric ischemia or following a patient after transjugular
intrahepatic portal systemic shunt (TIPS) creation. This article discusses indications,
protocol, and diagnostic criteria for abdominal vascular ultrasound. The vascular
lab can be used to investigate pathology in the abdomen either as a preliminary screening
tool to evaluate for a pathology such as mesenteric artery stenosis in a patient with
food fear and weight loss, renal artery stenosis in a patient with refractory hypertension
or renal failure, or as a diagnostic tool in follow up after a patient has undergone
a transjugular intrahepatic portal systemic shunt (TIPS) for portal hypertension.
The technical success of duplex ultrasonography of the abdomen can be compromised
by respiratory motion, obesity, and intestinal gas. Therefore, duplex scanning is
performed in the fasting state particularly in elective outpatient cases. In emergent
cases when pathology such as acute mesenteric ischemia is suspected evaluation with
CT angiography may be best.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Techniques in Vascular & Interventional RadiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
Available at: https://www.cms.gov/medicare-coverage-database/, Accessed July 27, 2022
- Evaluation of celiac and mesenteric vascular disease with duplex ultrasonography.J Ultrasound Med. 1992; 11: 481-485
- Detection of celiac axis and superior mesenteric artery occlusive disease with use of abdominal duplex scanning.J Vasc Surg. 1993; 17: 738-745
- Splanchnic arterial stenosis or occlusion: diagnosis at Doppler US.Radiology. 1999; 211: 405-410
- Duplex assessment of the splanchnic vasculature.Semin Ultrasound CT MR. 1992; 13: 34-39
- Mesenteric flow velocity variations as a function of angle of insonation.J Vasc Surg. 1990; 11: 688-694
- Duplex ultrasound criteria for diagnosis of splanchnic artery stenosis or occlusion.J Vasc Surg. 1991; 14 (discussion 518-20): 511-518
- Mesenteric duplex scanning: a blinded prospective study.J Vasc Surg. 1993; 17 (discussion 85-6): 79-84
- Mesenteric/celiac duplex ultrasound interpretation criteria revisited.J Vasc Surg. 2012; 55 (e6discussion 435-6): 428-436
- Ultrasound diagnostics of renal artery stenosis: Stenosis criteria, CEUS and recurrent in-stent stenosis.Gefasschirurgie. 2016; 21: 4-13https://doi.org/10.1007/s00772-015-0060-3
- Recommendations for ultrasonographic assessment of renal arteries.J Ultrason. 2018; 18: 338-343https://doi.org/10.15557/JoU.2018.0049
- Best duplex-sonographic criteria for the assessment of renal artery stenosis–correlation with intra- arterial pressure gradient.Ultraschall Med. 2007; 28: 45-51https://doi.org/10.1055/s-2007-962881
- Comparative accuracy of renal duplex sonographic parameters in the diagnosis of renal artery stenosis: paired and unpaired analysis.AJR Am J Roentgenol. 2007; 188: 798-811https://doi.org/10.2214/AJR.06.0355
- Utility of intrarenal Doppler ultrasound in the diagnosis of renal artery stenosis.Eur J Radiol. 2001; 40: 54-63https://doi.org/10.1016/s0720-048x(00)00263-1
- Renovascular hypertension and ischemic nephropathy.Circulation. 2005; 112: 1362-1374https://doi.org/10.1161/CIRCULATIONAHA.104.492348
- Renal artery stenting with noninvasive duplex ultrasound follow-up: 3-year results from the RENAISSANCE renal stent trial.Catheter Cardiovasc Interv. 2008; 72: 853-862https://doi.org/10.1002/ccd.21749
- Intrarenal color duplex ultrasonography: a window to vascular complications of renal transplants.J Ultrasound Med. 2007; 26: 1403-1418https://doi.org/10.7863/jum.2007.26.10.1403
- Imaging of the renal transplant: comparison of MRI with duplex sonography.Abdom Imaging. 2006; 31: 461-482https://doi.org/10.1007/s00261-005-0394-5
- Transjugular intrahepatic portosystemic shunt creation with the Viatorr expanded polytetrafluoroethylene–covered stent-graft.J Vasc Interv Radiol. 2004; 15: 239-248https://doi.org/10.1097/01.rvi.0000116194.44877.c1
- Doppler US of the Liver Made Simple.RadioGraphics. 2011; 31: 161-188https://doi.org/10.1148/rg.311105093
- Efficacy of Doppler ultrasonography for assessment of transjugular intrahepatic portosystemic shunt patency.Cardiovasc Intervent Radiol. 1996; 19: 397-400https://doi.org/10.1007/bf02577626
- Doppler sonography findings associated with transjugular intrahepatic portosystemic shunt malfunction.AJR Am J Roentgenol. 1997; 168: 467-472https://doi.org/10.2214/ajr.168.2.9016228
- Transjugular intrahepatic portosystemic shunt dysfunction: concordance of clinical findings, Doppler ultrasound examination, and shunt venography.J Clin Imaging Sci. 2016; 6: 29https://doi.org/10.4103/2156-7514.186510
- Sonography of Transjugular Intrahepatic Portosystemic Shunts: Detection of Elevated Portosystemic Gradients and Loss of Shunt Function.J Vasc Interv Radiol. 1997; 8: 549-556https://doi.org/10.1016/s1051-0443(97)70607-9
- hemodynamic findings at sonography before and after creation of a transjugular intrahepatic portosystemic shunt.AJR Am J Roentgenol. 1993; 160: 627-630https://doi.org/10.2214/ajr.160.3.8430568
- Utility of color Doppler ultrasonography predicting TIPS dysfunction.Am J Gastroenterol. 2005; 100: 2696-2701https://doi.org/10.1111/j.1572-0241.2005.00290.x
- Role of ultrasound surveillance of transjugular intrahepatic portosystemic shunts in the covered stent era.J Vasc Interv Radiol. 2006; 17: 1297-1305https://doi.org/10.1097/01.rvi.0000231951.47931.82
- Comparative results of Doppler sonography after TIPS using covered and bare stents.AJR Am J Roentgenol. 2006; 186: 1138-1143https://doi.org/10.2214/ajr.04.1831
- Preliminary results of a new expanded-polytetrafluoroethylene—covered stent-graft for transjugular intrahepatic portosystemic shunt procedures.AJR Am J Roentgenol. 2002; 178: 141-147https://doi.org/10.2214/ajr.178.1.1780141
Article info
Publication history
Published online: September 05, 2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.