0:00

This is a young female undergoing a scan

0:05

and there isn't much atherosclerosis.

0:07

There are definitely some atherosclerotic plaques in the iliac artery right

0:11

here in that left iliac artery. But overarchingly,

0:14

the external iliac arteries are patent,

0:17

as are the superficial femoral arteries on both sides.

0:20

There is some mild atherosclerosis on both sides as we're scrolling down,

0:24

but nothing significant as a focal high-grade stenosis.

0:27

There's some beam hardening artifacts that precludes assessment of the popliteal

0:31

artery.

0:32

And as we're scrolling down,

0:35

we can see that

0:37

from the perspective of a soft tissue, nothing seems bulky.

0:41

But again, we're seeing diffusely small caliber

0:44

arteries on both sides, more on the

0:48

right side, but really on both sides.

0:51

Turns out this person had a CREST syndrome,

0:55

and so with that clinical context, we

0:59

raised the possibility of vasoconstriction/Raynaud's phenomenon.

1:03

And this patient was determined to have that, and they were doing much

1:07

better after that. One way to differentiate if a person has

1:11

thrombosis or if it's just a temporary or

1:15

transient vasoconstriction or an exaggerated vascular response

1:19

is by repeat imaging after 48 to 72 hours.

1:22

If it was truly a vasoconstriction and not an embolus, then

1:27

these would have resumed to be normal caliber in that

1:30

interval duration.