14. Acute Carotid Thrombosis
Complication of endarterectomy/ stenting
Acute progression of Carotid stenosis
“ Culprit” lesion in an acute stroke
15.
16.
17.
18. Acute Carotid Thrombosis
Thrombus is heterogenously echogenic/ or very
hypo-echoic
Calibre of vessel is normal or expanded
Pulsations in vessel wall but NO FLOW
Swirling, sludge like flow in Carotid bulb
23. Free Floating Thrombus
Broad Base towards vessel wall
Tongue like projection
Oscillation with blood flow
24. Carotid Dissection
Due to hemorrhage into the intima with extension into
sub-intimal and sub-adventitial layers
Type A Dissection of Aortic Arch
45. Femoral Pseudoaneurysm
“Bubble like Anechoic /hypoechoic structure attached
to artery
Cylindrical neck along needle track
Bubble measures 1-3 cms
Neck variable length and width
46. Femoral Pseudoaneurysm
Swirling pattern within pseudo-aneurysm-----Yin-
Yang
To and Fro flow in the neck
Rarely only neck show flow
47.
48.
49.
50.
51.
52.
53.
54.
55. Treatment
USG guided compression- Upto 75% success
> Ihr compression
> painful
Thrombin Injection-99% success
0.5-1ml 0f 1000 IU/ml
Inadvertent injection into artery/vein very rare
56. Hematoma
Natural Outcome of Vascular Disruption
Due to poor Compression
Ecchymosis and Discomfort
Rarely large compressing the artery and nerve roots
Retroperitoneal and pelvic extention, Compartment
syndrome
57.
58.
59.
60. Haemotoma
Initially Echogenic / hypo-echoic well/ill defined area
Later becomes more well-defined and anechoic
Initial scan –exact measurements and even skin
marking
61. Acute Limb Ischemia
Embolic- Heart, Aorta, Iliac arteries, Aneurysm
Thrombosis over an existing plaque
Symptom onset is usually rapid-severe claudication, rest
pain, sensory loss and colour change
Depends upon collaterals
79. Diagnoses
Case 1- Superficial Femoral artery occlusion due to
atherosclerosis with significant small vessel disease
Case 2- Acute Distal Subclavian Artery Occlusion
Case 3-Significant Radial Artery Compromise