SDMS CME Credit – A Venous Pseudoaneurysm With an Unconventional Respirophasic Spectral Doppler Waveform in the Neck of the Pseudoaneurysm: Case Report

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Author: Cassey Young Noh, BS, RDMS, RVT

Category: Vascular Technology [VT]

Credit: 0.75 SDMS CME Credit

Objectives: After studying the article, you should be able to:

• Identify the sonographic and Doppler waveform characteristics that differentiate a venous pseudoaneurysm from an arterial pseudoaneurysm.

• Describe the clinical and imaging features of an idiopathic venous pseudoaneurysm arising from a non-pulsatile vein.

• Discuss the diagnostic considerations and management strategies for venous pseudoaneurysms with atypical presentations.

1. What type of Doppler waveform was observed in the neck of the venous pseudoaneurysm in the case report?

2. B. Pulsatile

3. C. Bidirectional “to-and-fro”

4. D. Respirophasic

Which of the following is a hallmark Doppler characteristic of an arterial pseudoaneurysm?

A. Continuous low-velocity flow

B. Monophasic waveform

C. Bidirectional “to-and-fro” spectral Doppler waveform

D. Respiratory variation

Which imaging modality can be used in conjunction with duplex ultrasound to differentiate arterial from venous pseudoaneurysm?

A. Noncontrast computed tomography (CT)

B. Contrast-enhanced ultrasound

C. CT angiography

D. Nuclear medicine scan

According to the case study, which vessel did the venous pseudoaneurysm originate from?

A. Popliteal vein

B. Profunda femoris vein

C. Distal femoral vein

D. Great saphenous vein

According to the article, what term describes a pseudoaneurysm with no identifiable cause?

A. Traumatic

B. Iatrogenic

C. Mycotic

D. Idiopathic

What is the primary management approach for a stable, idiopathic venous pseudoaneurysm?

A. Surgical excision

B. Percutaneous thrombin injection

C. Endovascular stent placement

D. Conservative anticoagulation therapy

According to the article, what characteristic of the Doppler waveform ruled out an arteriovenous fistula or arteriovenous malformation?

A. Presence of high velocity flow

B. Presence of bidirectional flow

C. Absence of arterialized pulsatility

D. Absence of respiratory variation