彩色超声测定阳萎患者阴茎血流的临床意义

应用彩色超声技术 (ＣＤＦＩ)检测 74例阳萎患者阴茎血流并与阴茎硬度对照 ,探讨不同硬度阴茎血流方面的改变 ,为血管性阳萎诊断提供客观依据。资料及方法　本组 74例。年龄 2 2～ 69岁。病程 1个月～ 1 0年。仪器Ａ ｃｕｓｏｎ1 2 8ｘｐ 1 0ｃ ,探头频率 7.5ＭＨｚ。患者仰卧位 ,上提阴茎 ,探头置于阴茎根部腹侧 ,测定海绵体动脉及背动脉血流收缩期峰值速度 (ＰＳＶ) ,舒张期末血流速度 (ＥＤＶ) ,阻力指数 (ＲＩ)及背静脉血流速度。然后用橡皮带束紧阴茎根部 ,自一侧阴茎海绵体内注射罂粟碱 60ｍｇ、前列腺素Ｅ 1 0 μｇ、2 %利多卡因 1ｍ…     

双功能彩色多普勒超声对静脉性阳萎血流动力学研究

１６例静脉性阳萎在海绵体血管活性药物注射后，采用双功能彩色多普勒超声（ＤＣＤＳ）来监测血流动力学变化，并用３２例功能性阳萎作对照组，背深动脉监测指标，１．舒张期内径（ＡＤ）２．最大收缩期流速（ＰＳＶ），３舒张末期流速（ＥＤＶ）４．阻力指数（ＲＩ）５．血流加速度（ＡＣＣ）。背深静脉监测指标，１．静脉内径（ＶＤ），２．血液流速（ＶＶ）。研究结果提示静脉阳萎ＥＤＶ〉Ｏｃｍ／ｓｅｃ，ＲＩ〈１，均Ｐ〈０．０     

阴茎血流动力学研究（附30例报告）

１９９５年５月～１９９６年１月，３０例功能性阳萎在海绵体血管活性药物注射诱导勃起前后，采用双功能彩色多普勒超声（ＤＣＤＳ）研究阴茎勃起血流动力学变化。背深动脉监测指标：舒张期内径（ＡＤ），最大收缩期流速（ＰＳＶ），舒张末期流速（ＥＤＶ），阻力指数（ＲＩ）。背深静脉监测指标：静脉内径（ＶＤ），血液流速（ＶＶ）。本研究结果提示：（１）ＰＳＶ≥２５ｃｍ／ｓ可作为判断有正常背深动脉功能。（２）ＥＤＶ≤０ｃｍ／ｓ，ＲＩ≥１可认为有完整静脉关闭机制存在。阴茎勃起后，静脉回流血量增加，静脉关闭机制间歇性开放。     

彩色多普勒超声在诊断血管性阴茎勃起障碍中的价值

彩色多普勒超声检测阴茎血流状态不仅可以鉴别血管性阴茎勃起障碍（ＥＤ）与非血管性ＥＤ,而且在区别动脉性ＥＤ与静脉性ＥＤ中有一定意义［１,２］。本文采用彩色多普勒超声检测４５名血管性和非血管性ＥＤ患者阴茎海绵体内注射血管活性药物前后阴茎深动脉血流状态,探讨彩色多普勒超声在诊断血管性ＥＤ中的价值。材料与方法一、临床资料本组共４５名,于１９９６年３月至１９９６年１０月间随机选自浙江医科大学男性科门诊ＥＤ患者,均经详细询问病史。年龄２１～５５岁,平均３３岁,病程２月～１８０月,平均２６月。其中２５例非血管…     

双功能彩色多普勒超声对静脉性阳萎血流动力学研究

１６例静脉性阳萎在海绵体血管活性药物注射后，采用双功能彩色多普勒超声（ＤＣＤＳ）来监测血流动力学变化，并用３２例功能性阳萎作对照组。背深动脉监测指标：１．舒张期内径（ＡＤ），２．最大收缩期流速（ＰＳＶ），３．舒张末期流速（ＥＤＶ），４．阻力指数（ＲＩ），５．血流加速度（ＡＣＣ）。背深静脉监测指标：１．静脉内径（ＶＤ），２．血液流速（ＶＶ）。研究结果提示静脉性阳萎ＥＤＶ＞Ｏｃｍ／ｓｅｃ，ＲＩ＜１，均Ｐ＜０．０１。背深静脉显示持续性、高流速血液回流。我们认为采用ＤＣＤＳ监测对客观评估静脉性阳萎血流动力学变化和静脉性阳萎的诊断均有一定价值。     

彩色多普勒超声在血管性阴茎勃起功能障碍诊断中的应用

目的评估阴茎海绵体注射后彩色多普勒超声对男性血管性阴茎勃起功能障碍（ED）患者诊断作用。方法47例ED患者经阴茎海绵体注射PGE1 30μg诱导勃起后行彩色超声多普勒检查左、右海绵体动脉血流指标,包括收缩期最大流速（PSV）,动脉舒张末期血流速度（EDV）,阻力指数（RI）。结果非血管性ED组41例（87.2%）,其中左、右海绵体动脉PSV分别〉25 cm/s者33例,左右海绵体动脉PSV相加〉50 cm/s者8例。动脉性ED组2例（4.25%）,左右海绵体动脉PSV均〈25 cm/s,背深静脉未见血流。静脉性ED组4例（8.51%）。结论阴茎海绵体注射血管活性药物后多普勒彩色超声对男性血管性ED检查是一种微创而准确的方法。     

药物性阴茎双功能超声对静脉性勃起功能障碍血流循环阻力的评估

本文自１９９５年５月～１９９６年６月对１６例静脉性勃起功能障碍（ＶＥＤ组）应用药物性阴茎双功能超声检测（ＰＰＤＵ）来观察静脉关闭机制受损所致阴茎血流循环阻力变化。阴茎血流循环阻力监测指标（１）阻力指数（ＲＩ），（２）Ａ／Ｂ比值，（３）搏动指数（ＰＩ）。并以３２例心理性勃起功能障碍（ＰＥＤ组）作对照。研究结果提示ＶＥＤ组ＲＩ＜１，Ａ／Ｂ比值＞０。ＰＥＤ组ＲＩ≥１，Ａ／Ｂ比值≤０。ＶＥＤ组ＰＩ平均数低于ＰＥＤ组，但参数有重叠现象，两组３项阻力指标参数有非常显著性差异（Ｐ＜０．０１）。我们认为静脉关闭机制障碍使海绵体内压下降，并引起阴茎血流循环阻力改变，阻力指标ＲＩ＜１和Ａ／Ｂ比值＞０可作为静脉关闭机制障碍判断标准，而ＰＩ的价值有待进一步探讨。     

直肠癌Miles术后局部复发的彩色多普勒血流显像研究

目的 探讨彩色多普勒血流显像对直肠癌Ｍｉｌｅｓ术后局部复发灶的诊断价值。方法 应用彩色多普勒血流显像仪经会阴和骶部检查直肠癌Ｍｉｌｅｓ术后骶前肿物患者５１例,分析肿块内血流程度及血流动力学定量指标：收缩期峰值速度（ｐｅａｋ ｓｙｓｔｏｌｉｃ ｖｅｌｏｃｉｔｙ,ＰＳＶ）,舒张末期速度（ｅｎｄ ｄｉａｓｔｏｌｉｃ ｖｅｌｏｃｉｔｙ,ＥＤＶ）,阻力指数（ｒｅｓｉｓｔｉｖｅ ｉｎｄｅｘ,ＲＩ）,搏动指数（ｐｕｌｓａｔｉｌｉｔｙ ｉｎｄｅｘ,ＰＩ）。结果 术后复发肿物血流信号以Ⅱ－Ⅲ为主,占８１．８２％（２７／３３）;良性病变以０－Ⅰ级为主,Ⅱ－Ⅲ级血流信号占２７．７８％（５／１８）。二者比较差异有显著性（χ＾２＝１４．５５,Ｐ〈０．０１）?术后复发肿块血流动力学特征：低ＰＳＶ、低ＰＩ、低ＲＩ、高ＥＤＶ。良、恶性病变四项     

勃起功能障碍的药物治疗

勃起功能障碍的药物治疗陈斌王益鑫１９８２年Ｖｉｒａｇ［１］首先报道应用血管活性药物——罂粟碱进行阴茎海绵体注射（ＩＣＩ）治疗勃起功能障碍（ＥＤ），使ＥＤ的诊断与治疗发生了革命性的变化。虽然ＩＣＩ可以使海绵体内局部药物达到很高浓度且无全身用药的副反应，...     

影像学检查对壶腹周围癌诊断价值的临床研究

目的评价各种检查手段对壶腹周围癌的诊断价值,帮助临床医师合理地选择检查方法。方法对胰头及壶腹周围癌患者３４例施行二维超声（Ｂｕｓ）、彩色多普勒超声（ＣＤＩ）、内镜超声（ＥＵＳ）、逆行性胆胰管造影（ＥＲＣＰ）、电子计算机断层扫描（ＣＴ）、核磁共振显像（ＭＲＩ）、血管造影（Ａｎｇｉｏ）及术中超声（ＯＵＳ）检查,比较它们的诊断效能。结果除Ａｎｇｉｏ的诊断符合率不足５０％外,Ｂｕｓ与ＣＤＩ,ＣＴ,ＭＲＩ的诊断符合率相当,约８０％（２７／３４）,ＥＵＳ,ＯＵＳ,ＥＲＣＰ的诊断率均达９０％（３２／３４）以上,检出全部直径大于和等于２ｃｍ的癌灶。直径小于２ｃｍ的癌灶１０例,ＥＵＳ及ＯＵＳ均检出８／１０例,ＥＲＣＰ在加用活体组织检查后全部检出,Ｂｕｓ、ＣＤＩ、ＣＴ、ＭＲＩ分别检出３例、３例、２例、４例,Ａｎｇｉｏ则无检出病例。结论ＥＵＳ和ＥＲＣＰ是目前检测微小癌灶最有效的方法,Ｂｕｓ因方便经济可做为首选的检查手段,ＣＤＩ从检测癌灶内血流信号有助判断癌灶来源     

腹腔镜完全腹膜外疝修补术对睾丸血流及血清睾酮的影响

【摘要】〓目的〓初步探讨腹腔镜完全腹膜外无张力腹股沟疝修补术(TEP)对睾丸血流及血清睾酮的影响。方法〓对我科住院行手术治疗的男性单侧腹股沟疝患者进行前瞻性研究,应用高频彩超对行腹腔镜下腹股沟疝修补的男性患者在术前48 h内,术后48 h内、2周内、1个月内用彩色超声分别测定患者患侧和对侧精索动脉血流量,包括收缩期峰值血流速度(PSV)和舒张末期血流速度(EDV)和睾丸体积,以及检测血清睾酮水平。结果〓共66例最终被选择入组。术前48 h内,患侧和对侧的PSV、EDV和睾丸体积差异均无明显异常(P>0.05);术后48 h及术后两周均检测到患侧的PSV、EDV和睾丸体积明显小于对侧,差异具有统计学意义(P<0.05)。而术后1个月内,患侧和对侧的PSV、EDV和睾丸体积差异均无统计学意义(P>0.05)。术前48 h内,术后48 h内、2周内及1个月的患者血浆睾酮水平的差异无统计学意义(P>0.05)。结论〓TEP术治疗腹股沟疝时,术后早期(2周内)可降低患侧的睾丸血流和睾丸体积,但术后1个月可恢复正常;TEP术对腹股沟疝患者的血清睾酮无明显影响。不需进行干预。     

Experimental study with Doppler ultrasound in partial chronic obstructive uropathy

IntroductionThis study has aimed to assess the hemodynamic parameters, Renal Resistive Index (RI), Peak Systolic Velocity (PSV), End-Diastolic Velocity (EDV) and Blood Flow of the Renal Artery (FR) by Doppler Ultrasound for diagnosis and monitoring postsurgical partial chronic obstructive uropathy.Material and methodsFifty pigs were used. The experiment was divided into three phases. Phase I consisted of a duplex-Doppler evaluation of the both kidneys to determine the parameters under study. The ratio of each index is calculated as the difference between the value of study kidney and the contralateral. After, a fluoroscopic examination was performed by compressive cystography, excretory urography and retrograde ureteropyelography. Finally, a model of partial right ureteral obstruction was created. After six weeks of the obstructive model, Phase II was begun with the diagnosis of the uropathy, by means of the aforementioned diagnostic methods and the endourological treatment was completed. Phase III is a follow-up performed at 6 months of treatment using the same methods as in the previous phases.ResultsOf the parameters studied, the EDV and its ratio showed greater sensitivity and specificity as a diagnostic marker of obstructive uropathy. In the postoperative monitoring, it was observed that the RI and the EDV returned to baseline levels, with the baseline values.ConclusionsThe ΔEDV and its ratio is the parameter that shows the greater efficacy for the diagnosis of chronic partial obstructive uropathy, however, it is insufficient to avoid conventional diagnostic techniques. All the parameters, mainly the EDV, have proven useful as complementary tests for monitoring after endourologic resolution of obstructive uropathy.     

Gender differences in blood velocities across carotid stenoses

OBJECTIVES: Carotid duplex scanning is the standard test for documenting carotid disease. Carotid endarterectomy effectively reduces stroke in selected patients with carotid artery disease. Data from large national randomized trials suggest that the benefits of CEA may be gender dependent. Because many diagnoses are made and treatment is based on the results of carotid duplex ultrasound scanning alone, it is important to determine whether different diagnostic thresholds should be used in men and women. The purpose of this study was 2-fold: to examine whether there is an overall gender difference in carotid velocity at similar arteriographic stenoses, and to determine whether there are significant differences at clinically relevant thresholds of disease. METHODS: A database of 938 carotid arteriogram entries was established prospectively, with accompanying measurements of peak systolic velocity (PSV) and end-diastolic velocity (EDV). The percent of internal carotid artery stenosis seen on arteriograms was calculated according to criteria from the North American Symptomatic Carotid Endarterectomy Trial. Analyses were made in 536 carotid arteries in men and 402 carotid arteries in women. In addition, the single most diseased artery per patient was analyzed by gender. PSV and EDV were averaged for data subsets according to 10% intervals of internal carotid artery stenoses. Velocity for each interval was compared between men and women with the Student t test. Receiver operator characteristic curves were developed to define optimal duplex criteria for 60% and 70% stenosis. RESULTS: For all intervals, PSV and EDV averaged 9% and 6% higher, respectively, in women than in men. Significant gender differences existed between PSV and EDV for 60% and 70% stenosis (P = .03). When a single vessel per patient was analyzed these observations persisted, but lost significance for PSV at 60% stenosis (P = .18). Receiver operator characteristic curves at 90% sensitivity demonstrated that optimal PSV for 60% stenosis was 160 cm/s and 180 cm/s, and for 70% stenosis was 185 cm/s and 202 cm/s, in male and female patients, respectively. CONCLUSIONS: Women have higher carotid blood flow velocity than men do. Gender differences exist, and are notably different at clinically relevant thresholds for intervention. These data indicate that different criteria should be used for interpreting carotid velocity profiles in women than in men, and have potentially important implications for patient care.     

Changes in peak systolic velocity induced by chronic therapy with phosphodiesterase type-5 inhibitor

The aim of this study was to assess the influence of chronic therapy with phosphodiesterase type-5 inhibitor on penile haemodynamics at colour Doppler ultrasound. Thirty patients affected by erectile dysfunction (ED) of different aetiology tested with the International Index of Erectile Function (IIEF-5) were evaluated with penile colour Doppler ultrasound during basic and dynamic phases (10 microg PGE1) before and after chronic self-administration of sildenafil citrate (dosage: 100 mg as required, two to three times a week) for a period of 5-20 months (mean: 12.3). Treatment was interrupted 14-21 days before the second ultrasound evaluation. Peak systolic velocity (PSV) and end-diastolic velocity (EDV) were recorded by means of colour Doppler; cut off values were 25 and 5 cm s(-1) respectively. Data were compared by nonparametric tests. Twenty-two of the 30 patients showed normal pre-treatment PSV, while eight of 30 had an insufficient arterial flow. Mean pre-treatment EDV was 4.7 +/- 0.5. After chronic therapy with sildenafil, a global improvement of 10.5% on PSV was seen (P < 0.001), without any statistical difference between patients with normal pre-treatment peak and those with a borderline one. No statistically significant changes were found for EDV (P = 0.98). It is concluded that chronic therapy with phosphodiesterase-5 inhibitor results in a significant improvement in PSV values, probably due to a penile chronic vasoactive enhancement.     

Spermatogenesis and spectral echo-colour Doppler traces from the main testicular artery

OBJECTIVE: To assess whether the peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistive index (RI) of testicular arteries may be useful in distinguishing the various causes of dyspermia when compared with follicle-stimulating hormone (FSH) and testicular volume. PATIENTS, SUBJECTS AND METHODS: The study included nine men with obstructive and 20 with unobstruc-tive azoospermia, 17 with oligoasthenospermia and clinical varicoceles, with male accessory glans inflammation (MAGI), 38 with undetermined oligoasthenospermia, 19 with MAGI, 11 with clinical varicoceles, 32 subjects with normal sperm analysis and recent paternity (fertile controls), and 15 with normal sperm analysis and a varicocele with recent paternity (fertile + varicoceles). Testicular volume, FSH, PSV, EDV and RI were compared among the dyspermic and/or control groups using analysis of variance. RESULTS: The PSV and RI were useful for identifying the different groups of patients, while EDV, FSH and testicular volume were not. Men with varicoceles, varicoceles + MAGI or fertile with varicoceles had the highest PSV and RI; fertile controls, those with obstructive azoospermia and MAGI had similar PSVs and RIs, those with unexplained oligoasthenospermia had a significantly lower PSV and RI, and men with unobstructive azoospermia had the lowest PSV and RI. CONCLUSIONS: The RI and PSV are reliable indicators for routine clinical use to identify infertile/dyspermic men, while EDV, FSH and testicular volume are not. The RI and especially PSV clearly differentiated obstructive from unobstructive azoospermia.     

多普勒超声技术动态观察血管性勃起功能障碍患者阴茎血流动力学的变化

目的动态观察多普勒超声技术配合阴茎海绵体注射在血管性勃起功能障碍患者诊断中的价值。方法120例疑血管性ED患者在阴茎注射PGE1后5min、10min和20min应用多普勒超声技术测量阴茎血流动力学变化,指标包括:收缩期峰值流速(PSV)、舒张末期峰值流速(EDV)、血流阻力指数(RI)。另100例心因性ED设为对照组。第一次注射后勃起不佳的患者3d后增加PGE1剂量重新检测。结果120例患者可以观察到明显的血流动力学变化,其中有动脉性ED者34例,静脉性ED 55例,混合血管性31例。ICI后不同时间的多普勒测量其血流动力学变化有一定差异。结论多普勒超声技术诊断血管性勃起功能障碍有一定意义。阴茎海绵体注射药物后须动态观察阴茎血流动力学的变化。     

B-mode ultrasound measurement of carotid bifurcation stenoses: is it reliable?

In the majority of cases, duplex ultrasonography (DU) is the sole imaging study necessary before carotid interventions. Duplex-derived internal carotid artery (ICA) peak systolic velocity (PSV), ICA end-diastolic velocity (EDV) and ICA/common carotid artery (CCA) PSV ratio are the most commonly utilized parameters for predicting critical carotid stenoses. However, the role of direct B-mode image measurement of maximal ICA narrowing is ill defined. The images and records of 192 patients who underwent both arteriography and duplex ultrasonography (DU) of 375 carotid arteries from January 1995 to November 2000 were reviewed. All DUs were performed by registered vascular technologists (n=6). Maximum arteriographic stenosis was determined according to the NASCET study design. With arteriography as the "gold standard," B-mode image (BMI) measurement of the maximal ICA luminal narrowing relative to the carotid bulb (n=162)as well as the peak systolic velocity in the internal carotid artery (PSVICA) (n=330), end-diastolic velocity in the internal carotid artery (EDV(ICA)) (n=198), and the ratio of the PSVs in both the ICA and the CCA (PSVICA/CCA) ratio (n=319) were subjected to receiver operator characteristics (ROC) curves for 3 clinically relevant stenoses thresholds: 50-99%, 60-99%, and 70-99%. A strong correlation was found between B-mode image (BMI)and the NASCET arteriographic measures of carotid stenosis (r =0.80;p<0.001) and was similar among the 6 technologists (r =0.74-0.89;p>0.2). The overall accuracy of BMI measurement to diagnose 50%, 60%,and 70% arteriographic carotid stenosis was 85.3%, 82.2%, and 87%, respectively. BMI measurement was similar to the most accurate PSV(ICA), EDV(ICA), and PSV(ICA/CCA) ratio at all 3 threshold stenoses levels (p>0.3). When combined with the velocity criteria, BMI measurement improved the positive predictive value (PPV) for all arteriographic stenoses thresholds by an average of 12.6% for PSV(ICA), 21.2% for EDV(ICA), and 14.2% for PSV(ICA/CCA) ratio. BMI measurement of carotid bifurcation narrowing is as reliable as duplex-derived velocity criteria in evaluating clinically relevant threshold ICA stenoses. The routine use of B-mode ultrasound in conjunction with the velocity parameters enhances the PPV of carotid DU. Our experience suggests that with current refinements in B-mode resolution, BMI stenosis measurements are accurate among experienced technologists and are a useful adjunct to duplex-derived velocity parameters.     

Correlation of invasive Doppler flow wire with renal duplex ultrasonography in the evaluation of renal artery stenosis: the Renal Artery Stenosis Invasive Doppler (RAIDER) study

OBJECTIVE: Determining renal resistive index (RI) in the setting of renal artery stenosis may predict which patients benefit from revascularization. Renal duplex ultrasonography (RDUS) is the traditional method of assessing RI, but it is not available in most invasive endovascular laboratories. Conversely, endovascular techniques to assess RI are available but not well validated. The primary goal was to determine if an invasive approach using an endovascular Doppler flow wire correlates with RI assessment using traditional noninvasive RDUS. METHODS: In a single-center prospective trial, patients were enrolled if they had known or suspected renovascular disease. A Doppler flow wire was placed in multiple segments of the renal artery, and peak (PSV) and end-diastolic velocities (EDV) were measured. RI was calculated using the formula: RI = [1 - (EDV/PSV)] x 100. Similarly, RI was also derived using standard RDUS. All patients underwent both RI techniques before any revascularization procedure. Secondary end points included assessing the correlation for pole-to-pole renal length assessment and PSV and EDV velocities using both invasive and noninvasive techniques. Pearson correlation coefficient calculations were used to determine degree of correlation. RESULTS: The study enrolled 20 patients, and 35 renal arteries were studied. Overall, Pearson correlation coefficient for invasive vs noninvasive RI assessment was 0.86 (95% confidence interval [CI], 0.73 to 0.93). The r values were 0.43 (95% CI, 0.11 to 0.67) for pole-to-pole renal length, 0.66 (95% CI, 0.54 to 0.76) for PSV, and 0.61 (95% CI, 0.48 to 0.72) for EDV determination. No major complications occurred during this study. Average time to perform invasive Doppler assessment was 10.4 +/- 7.4 minutes per artery. CONCLUSIONS: Invasive RI assessment using an endovascular flow wire technique correlates well with traditional noninvasive RDUS. A moderate statistical correlation also exists for pole-to-pole renal length, PSV, and EDV determinations. The procedure is safe and can be performed rapidly.     

Duplex Ultrasound Remains a Reliable Test Even After Carotid Stenting

Transluminal arterial stenting reduces vessel compliance and may alter accurate interpretation of flow velocities. We reviewed duplex ultrasonography (DUS) following carotid stenting to identify criteria indicative of severe recurrent stenosis. This is a single-center retrospective review of 158 carotid stenoses treated with carotid angioplasty and stenting (CAS) from April 2001 to December 2004. DUS was obtained preoperatively, postoperatively, and at 3-month intervals thereafter. Peak systolic velocity (PSV) and end diastolic velocity (EDV) were analyzed. Mean follow-up was 12 months (range 1-40). Mean age was 71 ± 9 years (range 51-91; 74% men, 26% women). Three patients (1.9%) developed restenosis and one (0.6%) developed an asymptomatic occlusion during follow-up. Average preoperative PSV was 373 ± 123 cm/sec (mean ± SD) and EDV was 148 ± 63 cm/sec. Immediate postoperative PSV and EDV decreased by an average of 70% (average 118 ± 45 cm/sec) and 72% (average 32 ± 15 cm/sec), respectively. In patients free from restenosis or occlusion, these reductions (range 65-80%) were maintained throughout follow-up and remained within 1-25% of immediate postoperative values. In patients suffering restenosis or occlusion, follow-up PSV and EDV increased 34% and 28%, respectively, compared to preoperative values. PSV and EDV increased by an average of 287% and 500%, respectively, compared to immediate postoperative values. Using criteria of PSV >170 cm/sec and a 50% increase of PSV over immediate postoperative values, restenosis or occlusion was detected with 100% sensitivity and specificity in our patients. Additionally, EDV >120 cm/sec and a 50% increase in EDV over immediate postoperative values detected restenosis and occlusion with 100% sensitivity and specificity. Presumed restenosis and occlusion detected by DUS were confirmed in all cases with angiography. Restenosis or occlusion after CAS at our institution can reliably be detected by carotid duplex using cut-off values of 170 cm/sec PSV, 120 cm/sec EDV, and >50% increase over immediate postoperative values. While these criteria are applied to patients undergoing CAS at our institution, they serve only as suggested guidelines for patient populations at other centers and must be customized to each Intersocietal Commission for the Accreditation of Vascular Laboratories-accredited vascular laboratory. Presented at the Fifteenth Annual Winter Meeting of the Peripheral Vascular Surgery Society, Steamboat Springs, CO, January 28-30, 2005.