ABC | Volume 112, Nº6, June 2019

Statement Vascular Ultrasound Statement from the Department of Cardiovascular Imaging of the Brazilian Society of Cardiology – 2019 Arq Bras Cardiol. 2019; 112(6):809-849 Figure 6 – Measurement of lumen reduction. (A) Smooth atheromatous plaque in the lumen. (B) Irregular atheromatous plaque in the lumen. Table 7 – Circumstances that can change the measurement of flow velocities Pathology Abnormalities in VUS Assessment alternatives Stenosis proximal to the common carotid artery or brachiocephalic artery Reduced absolute flow velocities (PSV and EDV) Using the velocity ratio and evaluation by the anatomical criterion Significant stenosis or contralateral carotid occlusion Compensatory increase in flow velocities Using the velocity ratio and evaluation by the anatomical criterion Arrhythmias (atrial fibrillation) Variable velocity peaks Waiting for the most regular period, or using an average of five beats and anatomical criterion Aortic valve stenosis Reduced absolute flow velocities (PSV and EDV) Using the velocity ratio and evaluation by the anatomical criterion Aortic valve insufficiency Increase in PSV flow, with the possibility of retrograde diastolic flow Using anatomical criterion or velocity ratio that does not involve EDV VUS: Vascular Ultrasound; EDV: end-diastolic velocity; PSV: peak systolic velocity. 2.6.2. Quantification of Stenosis Proximal stenosis (V0-V1) diagnosis results from the increase in flow velocities at the lesion site. The DCI-BSC standardization 3 suggests the values presented in table 8, adapted from the study by Hua et al. 30 Evaluate stenosis in the remaining segments with VUS based on multi-parameter analysis, such as turbulent flow with color Doppler, local increase in flow velocities, increase in velocity rates, and distal flow damping, since there are no tables of quantification of stenosis for these segments. 3. Abdominal Aorta and Branches 3.1. Abdominal Aortic Aneurysm 3.1.1. General Considerations Aneurysms are defined as a local dilation equal to or greater than 50% of the proximal or normal arterial diameter, necessarily involving all vessel layers. Even though the diameter of the abdominal aorta changes with age, gender, and biotype, 820