Imaging

In general, ultrasound (US) is the first-line imaging modality for peripheral aneurysm assessment. It is readily available, applicable on-site, inexpensive, patient friendly and enables non-invasive measurement of vessel diameters and detection of intravascular thrombus. Currently there is no standardized vascular US protocol available for imaging the PCHA. Such a protocol would enable worldwide uniform assessment of PCHA pathology. Moreover, given the complex local anatomy, including the frequently nearby originating and closely resembling deep brachial artery (DBA), evidence based recommendations and instructions for imaging would enable targeted PCHA identification and assessment.

 

Conclusions of the SPIKE study

The standardization of PCHA examination using the Shoulder PCHA pathology and digital Ischemia – UltraSound (SPI-US) protocol, combined with detailed knowledge on PCHA and DBA vessel characteristics and diameters, enabled targeted, accurate and precise diameter measurements, as well as PCHA aneurysm detection (Table 2). Among the examined elite volleyball players, proximal PCHA aneurysms were prevalent in 4.6% and associated with a specific branching type, namely a PCHA that originates directly from the axillary artery.

tabel2

 

 

Related articles:

– link SPI-US protocol

– Van de Pol D, Alaeikhanehshir S, Kuijer PPFM, Terpstra A, Pannekoek-Hekman MJC, Planken RN, Maas M. Reproducibility of the SPI-US protocol for ultrasound diameter measurements of the Posterior Circumflex Humeral Artery and Deep Brachial Artery: an inter-rater reliability study. European Radiology 2015. [Epub ahead of print]. doi:0.1007/s00330-015-4110-8. – link

– Van de Pol D, Maas M, Terpstra A, Pannekoek-Hekman MJC, Kuijer PPFM, Planken RN. B-mode ultrasound assessment of the Posterior Circumflex Humeral Artery – The SPI-US protocol: a technical procedure in 4-steps. Accepted for publication in The Journal of Ultrasound in Medicine. doi:10.7863/ultra.15.05037. – link expected soon

– Van de Pol D, Maas M, Terpstra A, Pannekoek-Hekman MJC, Alaeikhanehshir S, Kuijer PPFM, Planken RN. Ultrasound assessment of the Posterior Circumflex Humeral Artery in elite volleyball players: aneurysm prevalence, anatomy, branching pattern and vessel characteristics. Submitted. – link expected soon