Real-time ultrasonic imaging can provide useful clinical information in subjects with peripheral vascular disease. This report outlines the technique of imaging the extracranial arterial system and arterial segments that supply the lower extremities. It describes our interpretation of the ultrasonic image as it relates to the pathology of fatty streaks, smooth and complex plaques, occlusions and thrombus formations. Our experience consists of in excess of 2700 patients who were evaluated with real-time ultrasonic imaging in conjunction with noninvasive functional studies over 4 1/2 years. In our hands, real-time ultrasonic imaging performed in conjunction with functional noninvasive studies plays a more important role in the management of patients with cerebrovascular disease than in lower extremity vascular disease.
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