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Cerebrovascular Duplex Examinations Flashcards

7 cards from real CCI practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. Which waveform characteristic is MOST indicative of a high-grade internal carotid artery stenosis (>70%)?

    Answer: Increased peak systolic velocity with spectral broadening

    High-grade ICA stenosis produces markedly elevated PSV with turbulent post-stenotic spectral broadening due to disturbed flow.

  2. The ICA/CCA PSV ratio is used to grade ICA stenosis; a ratio greater than what value correlates with ≥70% stenosis by NASCET criteria?

    Answer: 4.0

    An ICA/CCA PSV ratio >4.0 is consistent with ≥70% ICA stenosis per the Society of Radiologists in Ultrasound consensus.

  3. A patient presents with a right-sided carotid bruit. Duplex shows a focal color aliasing jet in the proximal ICA with PSV of 320 cm/s and EDV of 110 cm/s. What is the most likely stenosis category?

    Answer: ≥70% stenosis

    PSV ≥300 cm/s and EDV ≥100 cm/s are consistent with ≥70% ICA stenosis by SRU criteria.

  4. When performing vertebral artery duplex examination, which segment is most commonly visualized using duplex ultrasound?

    Answer: V2 (intraforaminal segment)

    The V2 intraforaminal segment between C2 and C6 is the most consistently accessible window for vertebral artery duplex imaging.

  5. A patient with subclavian steal syndrome would demonstrate which vertebral artery flow pattern on the affected side during reactive hyperemia of the arm?

    Answer: Bidirectional (to-and-fro) flow converting to full retrograde

    Partial subclavian steal shows bidirectional flow at rest that converts to complete retrograde flow during arm hyperemia as demand increases.

  6. Which B-mode finding on carotid duplex is classified as a complex plaque and carries increased embolic risk?

    Answer: Heterogeneous plaque with irregular or ulcerated surface

    Heterogeneous plaques with irregular or ulcerated surfaces are associated with increased thromboembolic risk due to plaque instability.

  7. During carotid duplex, the sample volume should be placed at what angle to the vessel wall to obtain an accurate Doppler velocity measurement?

    Answer: 60 degrees or less

    A Doppler angle ≤60° is required for accurate velocity measurements; angles >60° cause significant overestimation of velocities.