0:00

I'm going to show you some complications, uh, related,

0:03

as related to the RTL system.

0:05

So this is a 67-year-old man who presented

0:08

with pain on a puncture side

0:09

after he had a corona orient angiogram.

0:12

And so we did a writing window ultrasound with Doppler

0:16

and what do we see?

0:18

Well, here, there is at the puncture site

0:24

an area of marked aliasing, right?

0:27

This is the color equivalent of a brewery

0:29

because basically there is tight stenosis,

0:34

as you can see here with a, with a angle corrected velocity

0:38

going up to 440 centimeters per second.

0:42

And so, uh, the,

0:44

there is a very tight stenosis at the puncture side.

0:48

Uh, more, uh, distally.

0:51

You have, again, the monophasic

0:53

flow that I've talked to you about.

0:54

Maybe it's not quite a par stratus,

0:55

but certainly having this, uh,

1:00

forward foreign diastole e femoral artery is abnormal.

1:04

Now, it may be that it's caused by this stenosis

1:06

or maybe the patient, remember the patient

1:08

like called me angiogram.

1:09

So he may have, he may be a vascular, he may have

1:13

multivessel disease

1:14

and he could have, um, other,

1:18

other vascular causes, you know, to, to cause that.

1:21

But anyway, this is a, uh,

1:23

abnormal flow in the femoral uh, artery.

1:29

Okay, so in this case, uh, there was a bru,

1:32

elevator stenosis, elevated velocity,

1:34

the right common femoral artery consistent

1:37

with the severe stenosis.

1:39

And so, again, change from a normal

1:42

phasic flow in a peripheral artery

1:44

to a monophasic flow may indicate a more proximal

1:48

significant stenosis or occlusion.

1:49

That's something that's very, very important to remember,

1:53

and this is not quite a progress tus.

1:56

Uh, it maybe because the patient doesn't have occlusion,

2:00

but have severe stenosis.

2:01

Nevertheless, that is an indication that you need

2:05

to think about something happening more centrally.