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 Table 9 – Recommendation from the Department of Cardiovascular Imaging for screening and follow-up of abdominal aortic aneurysm Screening • Men aged 65 to 75 years • Men aged 55 to 75 years with a family history of AAA and/or who smokes • Women aged 55 to 75 years with a family history of AAA and/or who smokes Follow-up interval • 2.6 to 2.9 cm – reevaluate in 5 years (sub-aneurysmal dilation) • 3.0 to 3.9 cm – 24 months • 4.0 to 4.5 cm – 12 months • 4.6 to 5.0 cm – 6 months • > 5.0 cm – 3 months Indication for intervention • ≥ 5.5 cm • AAA-related symptoms • Growth rate > 1.0 cm per year AAA: abdominal aortic aneurysm. Table 10 – Examination instructions and protocols for the study of abdominal aorta and branches Examination instructions Abdominal aorta Aortoiliac segment Mesenteric arteries and celiac trunk Renal arteries Low-frequency convex or sector transducers (2 to 5 MHz) x x x x Preferentially in the morning with 6- to 8-h fasting x x x x The patient should not smoke, chew gums, or consume carbonated beverages x x x x Optional antiflatulent x x x x Supine position with head raised at 30 o x x x x Lateral position x x – x Transverse, coronal, and longitudinal planes x x x x What to evaluate: B-scan: Dimensions x x x x Anatomic changes x x x x Morphology of walls and plaques x x x x Presence of thrombi x x – – Color Doppler: Aliasing x x x x Lack of flow (occlusion) x x x x Spectral Doppler: PSV – x x x PSV ratio (V2/V1) – x – – EDV – – x x Renal aortic ratio – – – x EDV: end-diastolic velocity; PSV: peak systolic velocity. right and left common iliac arteries and their external and internal branches. The evaluation uses B-scan, with transverse, coronal, and longitudinal planes to detect atheroma plaques and measure the diameters, especially if dilations are found. Take the anteroposterior (AP) measurement of the aneurysm during the peak systolic expansion, reporting if it was made from outer wall to outer wall (OTO) or inner wall to inner wall (ITI). • Screening : use the B-scan during the subxiphoid part of the echocardiogram or in routine abdominal ultrasound. • Diagnosis and follow-up : screen the aorta from the subxiphoid region to its bifurcation, followed by the study of iliac arteries and branches. • Preoperative assessment : descriptions, necessary measurements, and relevant data are described in figure 8. • Postoperative assessment : inform the surgical techniques used. They are described in detail in the DCI recommendations. 2 Essential information to include in the medical report (Figure 8): 822