ArterialDoppler Waveforms: Are Wetalkingthe Same Language?
Arterial Doppler waveforms:Are we talking the samelanguage?Pr G. MahéVascular MedicineCHU RennesGMahemaheguillaume@yahoo.frBackground Copy Here More than 200 million people have lower extremity peripheralartery disease (Fowkes et al., 2012) Analysis of Doppler waveforms To diagnose PAD To assess arterial flow when performing DuplexGMahe
RecommendationsRecommendations AHA 2006 AHA 2006 AHA 2016 AHA 2016 ESC 2017 ESC 2017Gerhard-Herman et al., Circulation, 2017Aboyans et al., EHJ, 2017GMaheGMaheHeterogeneous description of doppler waveformsHeterogeneous description of doppler waveformsHow do you describe this arterial flow?How do you describe this arterial flow?7GMahe8 GMahe
Heterogeneous description of doppler waveformsHeterogeneous description of doppler waveformsHow do you describe this arterial flow?How do you describe this arterial flow?9 GMaheHeterogeneous description of doppler waveformsA. Nicolaïdes, S. Yao, Investigation of Vascular Disorders, New York, 1981.10GMaheHeterogeneous description of doppler waveformsGMaheA. Nicolaïdes, S. Yao, Investigation of Vascular Disorders, New York, 1981.GMahe
Heterogenity among French Vascularmedicine studentsClassificationsType N or 0Type 1Type 2Type 3 19 Vascular medicine students were included 30 different arterial flows (CW and PW) (Scissons, 2008)TriphasicCathignol and Descotes, Nouvelle Presse, 1975Number of differentresponsesp 0,00514Degree of stenosis128Triphasic6BiphasicSharp monophasicMonophasic420.Scissons, Journal of Diagnostic Medical Sonography; 2008Without ClassificationOmarjee et al., Vasa, 2018 (in press)GMaheMethodology to define newclassificationSpronk et al., J Vasc surg, 2005GMaheNormal flow 1) Ascending branch and short rise time 2) Descending branch and short fall time 3) Negative diastolic component 4) Positive diastolic component 5) Return to baseline French College of Vascular Medicine teachers (CEMV) Two working days Literature 10 UniversitiesMahé G et al., Vasa, 2017High degree stenosiswithout collateralsNo stenosis10With Classification1Type 4GMahe1Mahé G et al., Vasa, 2017GMahe
Saint-Bonnet classification (1)Saint-Bonnet classification (2)Degree of stenosisDegree of stenosisHigh degree stenosiswithout collateralsNo stenosis1No stenosisGMaheMahé G et al., Vasa, 20171High degree stenosiswithout collateralsMahé G et al., Vasa, 2017GMaheRecommendations from the FrenchCollege of vascular medicine teachersSaint-Bonnet classification (3) Arterial Doppler waveforms show if there is blood flow impairment inthe arterial tree (CoR I, LoE B) The use of arterial Doppler waveforms morphology classification isrecommended to describe Doppler waveforms morphology in patientcare and research studies (CoR I, LoE C)Undefined flow: Saint-Bonnet U Vascular medicine residents/sonographers should be trained for arterialDoppler waveforms analysis (CoR I, LoE C)In some cases, arterial Doppler waveform morphology is undefined. In thatcase the blood flow is reported as Saint-Bonnet stage U.1Mahé G et al., Vasa, 2017GMahe1Mahé G et al., Vasa, 2017GMahe
Conclusion Doppler waveforms classification should be usedThanksG. Mahé MD, PhDProfessor of Vascular MedicineThorax and vessels DepartmentCHU Pontchaillou, Rennes, he1Mahé G et al., Vasa, 2017GMahe
Recommendations AHA 2006 AHA 2016 ESC 2017 Gerhard-Herman et al., Circulation, 2017 Aboyans et al., EHJ, 2017 GMahe_ Recommendations AHA 2006 AHA 2016 ESC 2017 GMahe_ 7 Heter
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Waveforms Extract “Target” Information A radar system probes its environment with specially designed waveforms to identify and characterize targets of interest. Detection For a given range, angle, and/or Doppler, decide if a target is or is not present. Example: Moving
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was created in the same way as the training data but calculated for faults and loads at different locations to those used for the training data. 4.2.1 Protection Relay Test Data The test data for the protection simulation network comprised a random selection of six fault waveforms and four load waveforms.
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