A moderate amount of pressure may be needed to push behind the bowel.
The aorta should be imaged in B mode from the diaphragm.
A Grey scale image of the aorta at the largest diameter, noting intraluminal echoes, should be obtained.
The maximal AP and Transverse Diameter are measured in the Proximal, Mid and Distal abdominal aorta.
The maximal AP and Transverse diameters should be measured in the origin of the iliac arteries and if an aneurysm is seen then the scan should be extended to include the common , internal and external iliac arteries .
If an aneurysm is identified ( >3cm in a male and >2.5cm in a female ) then the distance from the renal arteries should be measured . Supra or infra renal should be documented.
If the aneurysm extends into the bifurcation and includes one or both of the iliacs, this should be documented.
Colour duplex demonstrates the lumen and documents patency of the abdominal aorta. The normal aorta should have a triphasic waveform.
A “heel toe” movement to ensure an angle <60degrees is used for accuracy in any velocity measurements.
The patient should be fasted at least 6 hours before.
The study should be performed first thing in the morning.