VUA Ultrasound Criteria
Each diagnostic imaging centre will use their own grading criteria for vascular disease. It can be very confusing which criteria has been used if only a stenosis grading is given with no further explanation. At VUA we are completely transparent about our grading criteria which is present on all of our worksheets, as well as our website so you can also review the progression of a stenosis based on increasing velocities. Below are the current criteria we use (last updated May 2023).
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Carotid Criteria
Aorta and Iliac Artery Criteria
Lower Limb Arterial Criteria
Upper Limb Arterial Criteria
Pressure Studies Criteria
Renal Artery Criteria
Transplant Renal Artery Criteria
Mesenteric Artery Criteria
EVAR Endoleak Types
Increasing aneurysm sac size may be suggestive of an endoleak. The endoleak types are as follows:
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Type 1:
Inadequate seal between the graft and artery
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1A: Proximal attachment
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1B: Distal attachment
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2C: Iliac attachment
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Type 2:
Retrograde flow into sac via a branch vessel (eg.lumbar and/or IMA vessels)
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2A: One Vessel involved
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2B: Two or more vessels involved
Type 3:
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3A: Separation of the graft components
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3B: Graft fabric tear, fracture or hole
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Type 4:
Leak thorough the graft material itself due to graft porosity
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Type 5:
Endotension
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No leak seen however continued increase in residual sac size observed
Dialysis AVF Criteria
RED - Inflow (minimum diameter required):
Inadequate seal between the graft and artery
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Arteries: Proximal to the anastomosis
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>2mm Radial artery
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> 4mm Brachial artery
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Anastomosis: >2.7mm
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Swing Vein: First ~5cm from the anastomosis >2.7mm
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GREEN - Useable fistula:
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Useable segment of fistula for dialysis.
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>8cm length, >5mm diameter, <10mm depth​
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BLUE - Outflow:
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Remaining superficial vein and central veins
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3B: Graft fabric tear, fracture or hole
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Stenosis
Absolute diameter <2.7mm or PSV ratio >2.0
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Aneurysm
True aneurysm: >20mm autogenous dilation
False aneurysm: Any dilation in prosthetic graft or vessel false lumen
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Volume Flow
Measured across the inflow artery before the the anastomosis site
>500ml/min suggests functioning fistula
<500ml/min suggests impending fistula failure