Tristram Vascular Ultrasound

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Tristram Vascular Ultrasound is committed to providing high quality non-invasive vascular diagnostic imaging for the people of the Waikato and Central North Island. Tristram Vascular Ultrasound is proud of the fact that all of its scans are performed and interpreted by qualified and experienced vascular specialists. All reports are accompanied by a specialist vascular surgeon assessment of the best course of action. For urgent conditions a same-day vascular surgical consultation is available; please call Tristram Clinic receptionist at (07) 838-1035 for further information.

Ultrasound continues to be the first line of investigation for virtually all vascular disorders.
It is quick, non-invasive, does not require contrast, is relatively cheap and is performed in comfortable surroundings at Tristram Vascular Ultrasound.

The People of Tristram Vascular Ultrasound
Mr Ferrar
Mr David Ferrar
Mr Necas
Martin Necas
Mr Holdaway
Mr Chris Holdaway

Examinations and Services Offered

Broad range of diagnostic tests is offered by Tristram Vascular Ultrasound team. Virtually any vascular imaging tests performed today in vascular laboratories internationally are offered by Tristram Vascular Ultrasound.

All examinations are performed by qualified sonographer/sonologist using state-of-the-art equpiment to ensure highly accurate result. A comprehensive report is generated after each examination and you as a patient will have the opportunity to discuss the results with a vascular surgeon immediately. In instances when urgent medical treatment is needed, the first course of treatment can be given at the Tristram Clinic to avoid an unpleasant trip to the emergency room, or unnecessary return trip to your GP. The following are some interesting vascular ultrasound images. You may click on each image to learn more about the ultrasound tests during which these images were captured.

State-of-the-Art Ultrasound Imaging
Abnormal flow in a varicose vein Calf perforator causing
superficial varicosities
Normal tributaries of deep veins
behind the knee
Acute deep venous thrombosis
of a major leg vein
Normal Carotid Arteries branching
into ICA, ECA, and STA
Narrowing of the Carotid Artery due
to extensive plaque (red segment)
Spectral Doppler of severely
narrowed artery in the leg.
Turbulent Flow patterns in
large abdominal aortic aneurym
Large abdominal aortic aneurysm
with clot lining the inside of the vessel
Normal branching of groin arteries
with a synthetic graft attached
Leaking Intraluminal Aortic Graft Kink in an artery of the arm

Vascular Ultrasound Reports

Comprehensive vascular reports are produced on a unique system called "Genesis". This system not only provides important imaging and clinical data, but also contains anatomical and sometimes ultrasound images of the region examined and any abnormalities detected. In the past, such reports were drawn by hand and were often confusing, inaccurate, and difficult to store for future reference. The Genesis system breaks away from this poor tradition. It is an extremely flexible digital system which allows for a wide range of full-color-graphics to be included to illustrate and describe what abnormalities were detected. The data is stored digitally, is safeguarded for ever, and can be reviewed at any time. The following are examples of a Genesis system reports:

USS report USS report
Report of lower extremity venous ultrasound showing
a number of varicosities and problem areas.
Report of large abdominal aortic aneurysm providing
important information about aneurysm location and size.

For further information about vascular surgical procedures, contact Tristram Clinic, by phone or by email. To make an appointment for a vascular ultrasound examination , please phone 07 838-1035 or email our receptionist.

More detailed descriptions

For carotid artery disease, a good quality duplex ultrasound scan is usually the only imaging required. The indications for carotid artery duplex include: stroke, transient ischaemic attack (TIA), carotid bruit, transient monocular blindness, and for follow-up of carotid surgery, carotid stenting and carotid stenosis.

For lower limb vascular symptoms, there are a range of ultrasound tests available. Measurement of ankle-brachial pressure indices, when combined with waveform analysis, treadmill testing and sometimes photo-plethysmography provide a very accurate physiological assessment of arterial perfusion. Should there be abnormalities in these tests, then a lower limb arterial duplex which includes the aorta and iliac segment is the appropriate next test. Arteriography and magnetic resonance arteriography (MRA) should be reserved for those who require endovascular intervention or surgery, and for the occasional patient in whom ultrasound imaging is difficult (eg. the very obese).

Lower limb arterial duplex is essential in the follow-up of lower limb arterial reconstructive surgery. The detection of a graft stenosis on graft surveillance duplex prior to graft occlusion can save the time and expense of repeat surgery, as well as potentially saving limbs. All graft types can be effectively evaluated including: any lower extremity arterial bypass grafts, venous bypass grafts, as well as aortic endoluminal grafts.

Venous ultrasound is the best test for detecting deep venous thrombosis (DVT), and should be performed urgently in all cases when the diagnosis is suspected. We believe that all DVT scans should include a full assessment of the iliac veins and the calf veins. If required a vascular surgical opinion and commencement of anticoagulation is readily available.

Venous insufficiency studies are performed for a full assessment of function of the deep and superficial veins. These should be performed in patients with venous ulceration and in undiagnosed lower limb swelling. They are also useful in the follow-up of patients who have suffered from acute DVT. Many surgeons require a scan prior to performing varicose vein surgery (in particular in recurrent varicose veins and when there is a previous history of DVT. Venous ultrasound is of course an integral part of ultrasound guided sclerotherapy for varicose veins.

Abdominal aortic aneurysm (AAA) is a common condition in older males (6-8% of males aged morethan 65 will have an AAA). Duplex ultrasound is an extremely useful test for detecting AAA and is also useful for follow-up surveillance of small AAAs. It is also useful in assessing suitability for endoluminal repair and is an essential part of follow-up after endoluminal repair. All patients in whom there is suspicion of an AAA should have a duplex ultrasound scan of their abdominal aorta. This particularly includes first degree relatives of people who have been diagnosed with AAA.

Renal artery duplex is an effective test in the investigation of hypertension and/or renal failure. It is however difficult in the obese patient, and these patients are usually best imaged by MRA. Renal artery duplex is currently the only useful imaging modality for the follow-up of renal artery stents.

There are a number of other non-invasive investigations including:
  • Saphenous and arm vein mapping prior to vascular, cardiac or renal access surgery; assessment of the radial artery prior to coronary artery bypass grafting (CABG). The suitability of the vessel for harvesting is determined, and the vessel course is marked on patients skin for easy surgical localization
  • Mesenteric artery duplex for assessment of mesenteric insufficiency in patients with acute abdominal pain upon eating
  • Upper limb arterial and venous studies in patients with unique problems such as thoracic outlet syndrome, venous compromize and scarring caused by venous access lines, tissue damage from radiaion therapy
  • Dialysis fistula duplex can detect a wide variety of problems associated with dialysis grafts. The presence of graft stenosis, its precise location and haemodynamic impact on the graft performance can be evaluated.