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 13 – Ultrasonographic criteria to assess the native celiac trunk and superior mesenteric artery Artery Normal Doppler Stenosis ≥ 50% Stenosis ≥ 70% Occlusion CT Low-resistance PSV > 240 cm/s EDV > 40 cm/s PSV > 320 cm/s EDV > 100 cm/s Lack of flow Retrograde CHA flow SMA Fasting High-resistance PSV > 295 cm/s EDV > 45 cm/s PSV > 400 cm/s EDV > 70 cm/s Lack of flow SMA Postprandial Low-resistance PSV > 295 cm/s EDV > 45 cm/s PSV > 400 cm/s EDV > 70 cm/s Lack of flow CHA: common hepatic artery; SMA: superior mesenteric artery; CT: celiac trunk; EDV: end-diastolic velocity; PSV: peak systolic velocity. Figure 11 – Mesenteric vessels and abdominal aorta. (A) Transverse plane with B-scan showing the superior mesenteric artery (SMA) anteriorly and the abdominal aorta (AA) posteriorly. (B) Longitudinal plane of the abdominal aorta and emergence of the celiac trunk and SMA. A B S M A A A TRUNK SMA • Table 13 presents the ultrasonographic criteria to assess flow in CT and SMA. 2,41-43 3.3.4. Essential Information to Include in the Medical Report • Report if there were technical difficulties during the examination. • Presence or absence of atherosclerotic disease. • Lesion site. • Measurement of stenosis. • Measurement of PSV and EDV. 3.3.5. Examination Limitations Table 12 lists the examination limitations. 3.4. Renal Arteries 3.4.1. General Considerations Prevalence of renal artery stenosis (RAS) changes according to the population studied. RAS is the most common cause of secondary hypertension among the general population of hypertensive patients, representing approximately 1 to 6% of cases. 44,45 The most frequent cause of RAS is atherosclerosis (85% to 90% of cases), which often strikes the origin of and/ or the segment proximal to the renal artery and can be unilateral or bilateral. Its prevalence increases with age, diabetes, and atherosclerosis in other arterial sites. It is considered an independent predictor of adverse events such as acute myocardial infarction, CVA, and death due to cardiovascular causes. 45,46 Fibromuscular dysplasia – a non-inflammatory disease – is responsible for 10% of RAS cases. Its frequency among the general population is unknown, but it is more usually reported in young women. Renal artery involvement occurs in its mid- distal segment and is often bilateral. 47 With the quality improvement of imaging methods, RAS diagnosis became feasible and of great interest, aiming to identify patients who would benefit not only from drug therapy but also from renal revascularization procedures. Among the imaging examinations, VUS is the initial method 826