Liver Tx: Thrombus in Hepatic Artery detected with HFUS

This case demonstrates how High-Frequency Ultrasound (HFUS) can detect thrombus in the hepatic artery even when Transit Time Flow Measurement (TTFM) did not reveal any flow related issues.

Intraoperative completion control with TTFM and HFUS

Completion control with TTFM in the hepatic artery showed adequate HAF>100 mL/min with a PI<5 (Image 1).

While performing completion control with HFUS, a thrombus in the hepatic artery was revealed (Image 2). HFUS with Color Flow Mapping visualize how the blood is able to pass by the thrombus, resulting in normal TTFM parameters (Image 3 and Image 4).

This example shows that TTFM alone will not always be able to reveal thrombi in the lumen. Adding HFUS as routine quality control may aid in revealing issues that could cause postoperative complications.

Case attachments

Click images below to view.

TTFM in the hepatic artery showing adequate flow

TTFM in the hepatic artery showing adequate flow

Thrombus in the hepatic artery

Thrombus in the hepatic artery

HFUS with CFM showing how the blood is able to pass the thrombus in the hepatic artery

HFUS with CFM showing how the blood is able to pass the thrombus in the hepatic artery

HFUS with CFM showing how the blood is able to pass the thrombus in the hepatic artery

HFUS with CFM showing how the blood is able to pass the thrombus in the hepatic artery

Image 1

Image 1

Image 2

Image 2

Image 3

Image 3

Image 4

Image 4

Technology used

Medistim MiraQTM Vascular System with L15 High-Frequency Imaging Probe and Vascular TTFM Probes (PV series).

The case example consists only of a set of measurements and images using the MiraQTM during the surgery without further comments from the surgeon.

TTFM in the hepatic artery showing adequate flow

TTFM in the hepatic artery showing adequate flow

Thrombus in the hepatic artery

Thrombus in the hepatic artery

HFUS with CFM showing how the blood is able to pass the thrombus in the hepatic artery

HFUS with CFM showing how the blood is able to pass the thrombus in the hepatic artery

HFUS with CFM showing how the blood is able to pass the thrombus in the hepatic artery

HFUS with CFM showing how the blood is able to pass the thrombus in the hepatic artery