ARRS Case of the Week

ULTRASOUND: Vascular

Case Author: Shweta Bhatt, MD, University of Rochester Medical Center

History

77-year-old woman with tingling sensation in the left fifth digit and a history of arteriovenous fistula (basilic vein transposition to brachial artery) in the left arm.

Imaging Findings

Sagittal color Doppler image of the left brachial artery in the region of the anastomosis of the arteriovenous fistula (A) shows flow toward the hand in the proximal part of the artery and reversed flow away from the hand in the distal part of the brachial artery with color aliasing at the site of the anastomosis. Sagittal spectral Doppler image of the proximal brachial artery (B) shows a monophasic waveform flowing toward the hand in the artery. Sagittal spectral Doppler image of the distal brachial artery (C) shows reversal of flow away from the hand. Sagittal spectral Doppler image of the anastomosis at the brachial artery (D) shows color aliasing and elevated velocities at the anastomosis.

 

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