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Volume 46, Issue 3 - September 2022

This issue contains an update from the Society for Vascular Ultrasound leadership team, a book review focusing on ultrasound physics and instrumentation, outcomes following an exercise program and changes in cerebral blood flow, a comparative study of the right and left carotid arteries in patients with diabetes and hypertension, an illustration of a portal vein collateral with the diagnosis of portal vein hypertension, and a report of a pre-occlusive stenosis involving the left common carotid artery.

After reading and studying the papers used for CME in the September 2022 Issue of the Journal for Vascular Ultrasound, participants will be able to:
1. State the acoustic window used to image the middle cerebral artery.
2. List the formulas used to calculate the mean flow velocity and pulsatility index.
3. State the depth range use to acquire a Doppler signal from the middle cerebral artery.
4. List the risk markers of atherosclerosis and cerebrovascular disease.
5. Describe how to measure the intimal medial thickness in the carotid artery.
6. Explain why shear stress affects the left internal carotid artery more than the right internal carotid artery.
7. State the gold standard for diagnosing a patent foremen ovale.
8. List factors contributing to a falsely elevated ankle brachial index.
9. Compare the peak systolic velocities before and after transcarotid artery revascularization.
10. Explain the normal direction of blood flow in the portal vein.
11. State the modality used to evaluate the portal vein collateral.
12. Describe hepatofugal flow.
13. Explain the collateral flow pattern to the internal carotid artery from the external carotid artery with a common carotid high-grade stenosis.
14. Explain why the peak systolic velocity and pressure decreases distal to a high-grade stenosis.
15. List the Society of Radiologists in Ultrasound consensus criteria for a hemodynamically significant carotid artery stenosis.

Physician, Vascular Technologists and Sonographer members of SVU should find participating in this educational activity valuable

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the University of Cincinnati and the Society for Vascular Ultrasound.

The University of Cincinnati is accredited by the ACCME to provide continuing medical education for physicians.

The University of Cincinnati designates this Enduring Material activity for a maximum of 1 AMA PRA Category 1 Credit ™ per article. Physicians should claim only the credits commensurate with the extent of their participation in the activity.

SVU 2022 Oral Presentations

The University of Cincinnati designates this Enduring Material activity for a maximum of .5 AMA PRA Category 1 Credit ™ per article. Physicians should claim only the credits commensurate with the extent of their participation in the activity.

Doppler Study of the Left Common Carotid Artery with Pre-occlusive Stenosis
Adjacent Portal Vein Collateral with Retrograde Flow
A Comparative Study of the Right and Left Carotid Arteries in Relation to Age for Patients with Diabetes and Hypertension
Transcranial Color-Coded Doppler Cerebral Hemodynamics Following Aerobic Exercise Training: Outcomes from a Pilot Randomized Clinical Trial

Activity release date: September 1, 2022
Expiration date: August 31, 2025

This Enduring Material activity is available online at To receive credit, participants must read the CME articles, including the learning objectives and disclosure statements, as well as the full content of each of these articles, and then complete the post test and evaluation form. Upon successful completion of the post test (80% correct) and evaluation form, a CME certificate of participation will be awarded automatically. The certificate may be printed directly from the website.

In accordance with the ACCME Standards for Commercial Support, the authors for this journal have been asked to disclose to participants the existence of any financial interest and/or relationship(s) (e.g., paid speaker, employee, paid consultant on a board and/or committee for a commercial company) that would potentially affect the objectivity of his/her article or whose products or services may be mentioned during their article. The following disclosures were made:

David Dawson, MD, RVT, RPVI – No Relationships
Baylor Scott & White Health (Temple)
Temple, TX

R Eugene Zierler, MD RPVI
Editor-in-Chief, JVU
University of Washington School of Medicine
Seattle, WA

Sandra Yesenko, MHS, DHSc, RVT, RDMS, FSVU
Associate Editor for Education, JVU
Cleveland Clinic
Westlake, OH

Sandra Katanick, FSVU
Managing Editor, JVU
Hollywood, FL

Bruce Gebhardt, MD – No Relationships/Compliance
University of Cincinnati College of Medicine
Family Medicine

Barbara Forney – No Relationships/Compliance
University of Cincinnati College of Medicine
0ffice of Continuing Medical Education


Jesus Abreu, MD – No Relationships                       Lilla Juhasz, MD – No Relationships
Ahmed Abduljabar Al-Sabbagh – No Relationships     Oleg Kerbikov – No Relationships
Raham Bacha – No Relationships                                Iqra Manzoor – No Relationships
Erika Carrion – No Relationships                            Doragh Moneley -- No Relationships
Dane Cook, PhD – No Relationships            Ozioma Okonkwo, PhD – No Relationships
Robert Dempsey, MD – No Relationships     Ryan Pewowaruk, PhD – No Relationships
Ryan Dougherty, PhD – No Relationships                     Anmar Saleh – No Relationships
Samar Essa – No Relationships                            Clifford Sales, MD – No Relationships
Julian Gaitan, MEd – No Relationships                   Kimberly Shaver – No Relationships
Syed Gilani – No Relationships                            David Wedderman – No Relationships
Timothy Hess, PhD – No Relationships     Stephanie Wilbrand, PhD – No Relationships
Jonathan Izygon, MD – No Relationships                   David Williams – No Relationships
Elizabeth Wooster, MEd – No Relationships


Adam Gepner, MD – Relationship:
Beam Healthcare & Telehealth – President/Owner
VA Clinical Science Research and Development – Career Development Awardee

Carol Mitchell, PhD ACS RDMS RDCS RVT RTR – Relationship:
Davies Publishing, Inc – Textbook Author
Elsevier – Textbook Author, Chapter-may have future royalties
Wolters-Kluwer -- Textbook Author, Chapter-may have future royalties
W.L. Gore & Associates – Contracted Research Grants to University
   of Wisconsin-Madison

Jill Sommerset -- Relationship:
Cook Medical

Authors are required to inform the audience when they are discussing off-label, unapproved uses of devices and drugs. Physicians should consult full prescribing information before using any product mentioned during this educational activity.

The University of Cincinnati is committed to resolving all conflicts of interest issues that could arise as a result of prospective author significant relationships with drug or device manufacturer(s). The University of Cincinnati is committed to retaining only those authors with financial interests that can be reconciled with the goals and educational integrity of the CME activity.

The opinions expressed in this journal are those of the author and do not necessarily represent the views of the University of Cincinnati. The information is presented for the purpose of advancing the readers’ professional development.