Ecografie — Pseudoanevrism inghinal (MCB)

GROIN PSEUDOANEURYSM CHECK PROTOCOL

PURPOSE:

 To evaluate a site of recent arterial access for pseudoaneurysm or AV fistula.

INDICATIONS:

 Groin pain, swelling, hematoma or pulsatile mass following vascular access procedure.

EQUIPMENT:

 3.5-10 MHz linear probe

PATIENT PREPARATION & ASSESSMENT:

 Introduce yourself to the patient.
 Verify patient identity via two patient identifiers (name and date of birth) per hospital policy.  Explain the examination, its purpose and how long it will take.  Answer any questions the patient may have regarding the examination.  Obtain patient history including symptoms, signs, risk factors and other relevant history.

GENERAL GUIDELINES:

 Optimize equipment gain and display settings with respect to depth, dynamic range and focal zones while imaging vessels.  Add color Doppler to supplement grayscale images with proper color scale to demonstrate areas of high flow and color aliasing.  Set spectral Doppler gains to allow a spectral window and optimized to reduce artifacts.  Cursor sample size will be small and positioned parallel to the vessel wall and/or direction of blood flow.  A spectral Doppler angle of 45-60 degrees or less will be used to measure velocities. Note exceptions to these angles on the technologist worksheet.  Send the measurements screenshot page if your machine is capable.  Any deviations from the standard protocol and any limitations to the examination should be documented on the technologist worksheet for future reference and for repeatability in follow-up studies.  Report preliminary critical findings to the referring clinician when appropriate (i.e. immediate medical attention may be warranted) and according to hospital policy.

DOCUMENTATION:

Grayscale Imaging  Document transverse grayscale images of the following:  Common femoral artery and vein  Proximal femoral artery and vein

Groin Pseudoaneurysm Protocol – Last Updated 5/8/2018 - Page 1 of 2

 Document longitudinal grayscale images of the following:  Common femoral artery and vein  Proximal femoral artery and vein

Color Doppler Imaging  Document transverse color Doppler images of the following:  Common femoral artery and vein  Proximal femoral artery and vein  Document longitudinal color Doppler images of the following:  Common femoral artery and vein  Proximal femoral artery and vein

Spectral Doppler Waveforms  Document longitudinal spectral Doppler images of the following:  Common femoral artery – measure PSV  Proximal femoral artery – measure PSV  Common femoral vein – augment vein  Proximal femoral vein – augment vein

Pseudoaneurysm, Hematoma, AV Fistula  If a pseudoaneurysm is present:  Measure the transverse and longitudinal dimensions of the pseudoaneurysm sac.  Measure the transverse dimensions of the pseudoaneurysm neck.  Document the pseudoaneurysm sac without and with Color Doppler.  Document the waveforms within the pseudoaneurysm sac and at the pseudoaneurysm neck with Spectral Doppler.  If a hematoma is present:  Measure the transverse and longitudinal dimensions of the hematoma.  Document the hematoma without and with Color Doppler.  If an arteriovenous fistula is present:  Measure the transverse and longitudinal dimensions of the arteriovenous connection.

Groin Pseudoaneurysm Protocol – Last Updated 5/8/2018 - Page 2 of 2