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 18 – Arterial flow patterns in various situations Name Clinical meaning Occurrence situation Triphasic Found in young and normal individuals Normal Triphasic without the elastic component Found in old adults with reduced vessel elasticity ● Normal old adults ● Bad US beam alignment Biphasic hyperemic Without retrograde component, but reaches the baseline. Increased velocities ● Inflammatory process ● Normal reactive vasodilation Biphasic post-obstructive Without retrograde component, but reaches the baseline. Low velocities After moderate obstructions Biphasic with retrograde pandiastolic component Retrograde pandiastolic component. Usually with normal velocities Vessels that provide collateral to other stenotic arteries. In most cases, vessels without proximal lesions Biphasic "to-and-fro" Pronounced retrograde pandiastolic component ● Pseudoaneurysm ● Type II endoleak Acute monophasic Low velocity, with little increase in acceleration time Moderate and moderate to severe post- stenosis, WITH vasodilation reserve Damped monophasic Low velocity, with increased acceleration time Severe post-stenosis or post-occlusion, WITH vasodilation reserve Extremely damped monophasic Very low velocity, with high increase in acceleration time Post-occlusion, WITH vasodilation reserve Monophasic without diastole Extremely low velocity, with increased acceleration time, without diastole flow Post-occlusion, WITHOUT vasodilation reserve. Severe multisegmental lesions Continuous Extremely low velocity, with acceleration time so increased that it is not possible to differentiate PSV from EDV Post-occlusion, WITH vasodilation reserve. Severe multisegmental lesions Retrograde Low velocity, can be damped or not, and can even have a retrograde component Retrograde filling of a vessel with proximal occlusion EDV: end-diastolic velocity; PSV: peak systolic velocity. 830