0:00

Okay, so this is another patient given me, given

0:03

to me by my friend Dr.

0:04

But again, in the upper extremity, same concept.

0:09

So if you look at, so this patient had a, um,

0:15

digit discolor, the acute fifth digit pain

0:18

and discoloration on the left side.

0:21

And so when they did the doppler, um,

0:26

we couldn't really see centrally, right?

0:28

They couldn't see centrally.

0:29

But this is what was noticed that's very important is that

0:32

in the axillary artery as well as the radial artery,

0:36

you have a tars harvest wave one.

0:40

This should be a strong phasic flow

0:43

with sharp systolic up stroke

0:45

and reversal ofone diastole, we did not see that.

0:48

So based on that alone,

0:50

because they couldn't see centrally where the problem was,

0:52

ultrasound cannot reach there.

0:54

But based on that, they said, look, okay,

0:56

this patient may have a more central occlusion of stenosis.

1:00

The patient needs a CTA.

1:02

And so when they did the CTA, you can see that in the

1:06

subclavian artery here, there is a clot

1:09

with near complete occlusion on the mip.

1:11

Very nicely shown. So again,

1:13

this is why I think we dopper what's so important.

1:16

It's not just to see there is flow and no flow

1:18

'cause the, the, the, the arteries are patent here,

1:20

however, analyze the darker spectrum

1:23

and from that infer that there may be something that's

1:26

beyond what you can see and recommend the appropriate study.