SVU 2025 Annual Conference Abdominal Session-SVU 2025 Annual Conference Abdominal Session

Video Transcription

Video Summary

The session focused on the expanding role of vascular ultrasound in assessing abdominal and retroperitoneal vessels, targeting sonographers and clinicians. It covered mesenteric artery evaluation, abdominal aortic and iliac imaging, aneurysm management, post-endovascular aneurysm repair (EVAR) surveillance, contrast-enhanced ultrasound, and venous congestion assessment using the VEXUS score. <br /><br />Dr. Patrick Washko emphasized the importance of understanding arterial spectral waveforms, differentiating high- and low-resistance vascular beds, and the common sites of stenosis in mesenteric arteries. He highlighted sonographic features of median arcuate ligament syndrome and the significance of recognizing anatomical variants for accurate diagnosis.<br /><br />Melissa Warren addressed a comprehensive approach to aortic and iliac duplex ultrasound, stressing the need for consistent measurement locations to avoid variability, the significance of assessing flow waveforms, and careful evaluation of EVAR grafts, including graft apposition and detection of endoleaks with optimized color Doppler settings.<br /><br />Dr. Anita Dua reviewed abdominal aortic aneurysm (AAA) pathophysiology, risk factors, management thresholds, and trends toward complex endovascular repairs like fenestrated and physician-modified endografts (PMAGs). She introduced innovations aiming to reduce delivery system size by utilizing transaxillary access, potentially improving treatment options for patients with challenging iliac access.<br /><br />Dr. John Carson reiterated duplex ultrasound as the gold standard for aneurysm screening and surveillance, detailed aneurysm classification, and discussed thrombus and embolus implications. He underscored the importance of ultrasound in diagnosis and monitoring to prevent complications.<br /><br />Dr. Finch presented contrast-enhanced ultrasound in post-EVAR imaging, demonstrating its superiority in detecting low-flow endoleaks undetected by CT or Doppler, aiding in management decisions.<br /><br />Aaron Enders introduced the VEXUS scoring system, combining inferior vena cava size and Doppler waveforms of hepatic, portal, and intrarenal veins to grade systemic venous congestion. This tool guides fluid management in critically ill patients by noninvasively assessing volume overload.<br /><br />The session concluded with discussions on optimizing imaging protocols, training in advanced ultrasound techniques, and clinical applications of ultrasound in vascular disease management.

Keywords

vascular ultrasound

abdominal vessels

retroperitoneal vessels

mesenteric artery evaluation

abdominal aortic aneurysm

iliac imaging

aneurysm management

post-EVAR surveillance

contrast-enhanced ultrasound

venous congestion assessment

VEXUS score

arterial spectral waveforms

median arcuate ligament syndrome

endoleak detection

transaxillary access