Evaluation and Management of Peripheral
Vascular Injury
Part 1

Annotation for Point K

 Duplex ultrasonography is a combination of real-time B (brightness)-mode imaging and pulsed Doppler velocimetry that demonstrates anatomic relationships and flow.⁵² Flow to and from the point of the Doppler examination can be represented on a color scale as well. Numerous clinical studies have documented the excellent accuracy of duplex ultrasonography in assessing arterial injuries. While sensitivity has ranged from 50% to 100%, specificity and accuracy have consistently exceeded 95%.^28,53–55 Disadvantages of this diagnostic approach include the initial cost of the equipment, need for 24-hour availability of a registered vascular technologist or experienced vascular surgeon trained in duplex, and concerns about studies in the axilla and bifurcated arteries in older studies.⁵⁶