• Adapt the exam to clinical setting and patient condition (patient position, physical environment, medications, etc.)
• Adjust study to minimize artifacts
• Aortoiliac congenital anomalies
• Aortoiliac disease (atherosclerosis, aneurysm, dissection, etc.)
• Aortoiliac scan technique in obtaining and documenting diagnostic images
• Aortoiliac vasculature
• Apply appropriate use criteria
• Apply physical principles
• Appropriate indications and contraindications for vascular exams
• Appropriate preparations for the test
• Appropriate procedural imaging: pre-procedure, during procedure, and post-procedure
• Artifacts, their causes, and their implications on the study
• Assess abnormal vasculature
• Assess organs related to abnormal vasculature (liver, kidney, spleen, pancreas, gallbladder, thyroid, etc.)
• Assess the appropriateness of the exam (per indications, by applying Appropriate Use Criteria, etc.)
• Calculate, perform, and analyze resistive indices and acceleration times
• Collaborate regarding exam protocols (including discussions, optional images, modifications, timing, and diagnostic criteria)
• Common causes of failure/rejection of surgically altered anatomy/vasculature
• Communicate professionally with patient and provider
• Compare exam findings to correlative studies
• Contraindications to a procedure
• Contraindications to a vascular exam
• Correlate information from various types of imaging studies
• Correlate vascular exam findings with other imaging modalities
• Critical findings (aneurysm, acute deep vein thrombosis, critical stenosis, etc.)
• Dialysis access
• Document and communicate findings
• Document preliminary impression/findings and technical limitations
• Document preliminary impression/findings and technical limitations, and verify images are appropriately archived for interpretation
• Effects of tourniquet on hemodynamics
• Establish rapport and interview patient
• Evaluate effects of limb size and cuff diameter
• Evaluate effects of tourniquet on hemodynamics
• Evaluate pathology, perfusion, and function
• Evaluate post-procedural vasculature (after evar, ivc filter, venous ablation, bypass grafts, tips, stents, etc.)
• Evaluate surgically altered anatomy and pathology
• Exam protocols
• Expected post-procedural findings/potential complications
• Extracranial cerebrovascular disease
• Extracranial cerebrovascular system
• Hemodynamics as it related to surgically altered anatomy and pathology
• Hemodynamics as it relates to normal anatomy
• Hemodynamics as it relates to pathology
• Hepatoportal system
• Hepatoportal system disease (thrombosis, Budd-Chiari syndrome, portal hypertension, etc.)
• Identify anatomic variants
• Identify and communicate critical findings
• Identify and document incidental findings
• Identify artifacts related to vascular imaging, and document and/or modify the exam as needed
• Identify pathology
• Implications of patient position, physical environment, and patient condition on vascular exams (hydrostatic pressure, etc.)
• Implications of various laboratory values
• Incidental findings (thyroid mass, Baker cyst, carotid body tumor, etc.)
• Inferior vena cava and/or iliac vein disease (thrombosis, extrinsic compression, etc.)
• Inferior vena cava and/or iliac veins
• Instrumentation and its appropriate use
• Interpret and follow patient identification protocols
• Intracranial cerebrovascular disease (TCD and TCI) (for stroke, for vasospasm, agitated saline for patent foramen ovale (PFO), for intraoperative emboli monitoring, etc.)
• Intracranial cerebrovascular exams (transcranial Doppler (TCD) and transcranial imaging (TCI))
• Lower extremity veins
• Lower extremity venous disease (thrombosis, extrinsic compression, etc.)
• Manually calculate pressure indices (ankle-brachial index (ABI), segmental pressures, etc.)
• Mesenteric vasculature
• Mesenteric vasculature disease (atherosclerosis, aneurysm, dissection, thrombosis, extrinsic compression, etc.)
• Modify exam based on patient condition and body habitus
• Modify exam based on real-time findings
• Monitor patient condition (including safety and comfort)
• Native lower extremity artery disease (atherosclerosis, aneurysm, dissection, extrinsic compression, etc.)
• Native upper extremity artery disease (atherosclerosis, aneurysm, dissection, thoracic outlet syndrome, etc.)
• Normal vascular flow patterns using spectral, color, and power Doppler
• Obtain and evaluate patient history
• Obtain appropriate diagnostic waveforms/pressures with and without provocative/exercise maneuvers
• Obtain appropriate post-procedural diagnostic images
• Obtain appropriate venous photoplethysmography (PPG) diagnostic waveforms (with and without tourniquets; plantar flexion and dorsiflexion)
• Optimize recordings
• Organs related to vasculature (liver, kidney, spleen, pancreas, gallbladder, thyroid, etc.)
• Other imaging modalities (mri, ct, conventional angiography, etc.)
• Participate in manual compression of pseudoaneurysms
• Participate in quality assurance activities and monitor safety
• Participate in ultrasound-guided procedures/intraoperative assessment
• Pathology, perfusion, and function
• Pathology, Perfusion, and Function 32%
• Pathophysiology of vascular disease
• Perform physiologic arterial examinations
• Perform physiologic venous examinations
• Physiologic examinations
• Physiologic Examinations 12%
• Placement of venous ppg sensors and tourniquets
• Post intervention (endovascular aneurysm repair (EVAR), inferior vena cava (IVC) filter, venous ablation, bypass grafts, transjugular intrahepatic portosystemic shunt (TIPS), stents, etc.)
• Potential effects of patient medications on exam
• Preparation, documentation, and communication
• Preparation, Documentation, and Communication 8%
• Prepare for examination
• Procedure protocol and required resources
• Protocol for critical findings notification
• Provide appropriate patient care
• Provide guidance during a procedure
• Provide guidance for thrombin injections of pseudoaneurysms
• Provide guidance for venous ablation procedures
• Provocative/exercise maneuvers and their effect on circulation
• Quality assurance, safety, and physical principles
• Quality Assurance, Safety, and Physical Principles 14%
• Recognize and apply proper scan technique in evaluating and documenting pathology
• Recognize and document abnormal vascular flow patterns using spectral, color, and power doppler
• Renal vasculature
• Renal vasculature disease (atherosclerosis, aneurysm, dissection, thrombosis, extrinsic compression, fibromuscular dysplasia, etc.)
• Review and confirm patient information (patient identity, clinical history, previous imaging studies, lab findings, interventions, etc.), and communicate exam process to patient
• Scanning techniques and patient/sonographer positioning
• Select correct instrumentation based on protocol and patient body habitus
• Select the appropriate instrumentation (photoplethysmography (PPG) sensors, cuffs, presets, protocols, etc.)
• Select the appropriate venous photoplethysmography (PPG) instrumentation (sensors, presets, protocols, etc.)
• Signs and symptoms pertaining to the vascular exam
• Sonographer's role during procedure
• Sonographic appearance of abnormal anatomy and vascular structures
• Sonographic appearance of anatomy, landmarks, and vascular structures
• Sonographic appearance of surgically altered anatomy/vasculature
• Surgical procedures related to dialysis access, bypass grafts, stents, organ transplants, venous ablation, etc.
• Surgically altered anatomy and pathology
• Surgically Altered Anatomy and Pathology 6%
• Synthesize information from various sources in the patient's medical history
• Technical limitations of vascular exams
• Transplanted organs
• Ultrasound-guided procedures/intraoperative assessment
• Ultrasound-guided Procedures/Intraoperative Assessment 7%
• Understand an operative report and its impact on sonographic appearance and technique
• Upper extremity veins
• Upper extremity venous disease (thrombosis, thoracic outlet syndrome, extrinsic compression, etc.)
• Utilize appropriate exam protocols
• Utilize resources, such as physicians, literature, or peers
• Vein mapping
• Venous insufficiency
• Verify that exam is properly archived





All Topics Covered

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General Information
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Cerebrovascular Evaluation:
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Anatomy, Pathology, Physiology and Exam Techniques
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Transcranial Evaluation:
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Anatomy, Pathology, Physiology and Exam Techniques
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Lower and Upper Extremity Arterial Evaluation:
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Anatomy, Pathology, Physiology and Exam Techniques
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Lower and Upper Extremity Venous Evaluation:
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Anatomy, Pathology, Physiology and Exam Techniques
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Abdominal Vascular Evaluation:
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Anatomy, Pathology, Physiology and Exam Techniques
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Vascular Hemodynamics
Content Covered

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