0:00

In this video,

0:01

I'm gonna review how to obtain subclavian artery measurements using three D

0:06

software. With this particular three D software, we have, uh,

0:09

created a curve planar image,

0:11

which goes through the entire left subclavian artery for this example.

0:15

And you can see that we can spin around it just like a typical curve planar

0:19

reformat. You can spin around it in all different directions. First,

0:23

you can take a look at the vessel.

0:24

You can use this spin to assess the degree of calcification,

0:28

which in this case I certainly would call mild in this particular case.

0:31

You can use this three d reformat to assess calcification and tortuosity as you

0:35

can do on many, uh, of these different, um, software systems. And in this case,

0:39

I think there's not really any significant tortuosity and very mild

0:43

calcification. So let's take a look again at the curve planer.

0:48

So usually when you're assessing the subclavian arteries,

0:50

there's two spots where you're most likely to encounter significant narrowing.

0:54

The first is at the origin from the aortic arch.

0:58

And you can see in this patient from the short axis view here,

1:03

I can blow that up,

1:04

that there is some calcification at the origin from the aortic arch.

1:10

And this particular software does some automated measurements.

1:12

It segments out the actual vessel diameters and gives you the minimum and

1:15

maximum measurements.

1:17

And this overlay is the size of the catheter you can put in through this vessel.

1:22

So we don't tend to report the, the catheter size,

1:24

we just report the minimum and the maximum measurements. So in this case,

1:27

the minimum is eight and a half, maximum 14.

1:30

So certainly large enough to accommodate whatever catheter they want to place.

1:36

The other trouble spot that you'll often find for the SubCal arteries is right

1:40

between the first rib and the clavicle. So let's see, as we scroll up,

1:45

we should see right here, you can see there's the clavicle coming in.

1:49

Here's the first rib.

1:50

There's actually a lot of space in this particular patient,

1:53

so no real issues there.

1:55

But you can see in some patients this space between the first rib and clavicle

1:58

is much more narrow and you might get some compression of the vessel there.

2:01

So here you can, as we hover,

2:03

we see that the diameters of brown six millimeters for the minimum.

2:07

So that looks pretty good. So in this particular case,

2:11

most likely in, you know,

2:13

what you tend to do is just sort of scroll through and look visually for any,

2:16

um, significant areas of narrowing, and then measure the minimum. In this case,

2:21

I would measure a minimum for the subclavian artery as I scroll through of

2:24

around five millimeters. And that's, uh, way distal at the axillary region.

2:28

Usually where they're gonna go insert their catheters is right around

2:33

the, the edge, um, here, sort of like the lateral clavicle area.

2:38

So usually, uh, diameters out here in the aary region aren't quite as important.

2:42

So for their purposes,

2:44

I think the minimum is around the six millimeter range for this particular case,

2:49

based on the diameters that we see as we scroll through the areas around the

2:53

level of the clavicle.