Traditionally, technologists have performed vascular ultrasound procedures and surgeons have interpreted the results. With the technologic advancements in vascular ultrasound imaging, surgeons are now encouraged to perform and interpret their own examinations. Particularly when using intraoperative ultrasound, surgeons should be capable of performing and interpreting ultrasound examinations and then using that information to make decisions about the operative strategy. Whether the surgeon performs the ultrasound examination alone or in conjunction with a technologist and/or radiologist depends upon the clinical situation (Figure 1). For example, frequent performance of an intraoperative vascular ultrasound procedure by the surgical team may not require the presence of a technologist; however, the presence of a technologist or radiologist in the operating room is preferred by some when doing a complex procedure in which advanced ultrasound skills are needed. In any case, the vascular surgeon should be skillful with the interpretation of the study, and quality assurance evaluations should be an integral part of all such examinations. This may be accomplished by initially performing the ultrasound examination and then comparing it to a “gold standard,” such as angiography, operative findings,<sup>11 Merchant L., Pilcher D.B., Ricci M.A. Carotid duplex QA without angiography J Vasc Tech 1994 ;  18 : 208

Cliquez ici pour aller à la section Références</sup> or clinical outcomes such as vessel patency.

The ultrasound equipment necessary to perform vascular ultrasound requires an assessment of the anatomy of the vessel and the “physiology” of flow within it. High-resolution B-mode imaging visualizes the anatomic components of the vessel, including plaque morphology, intimal flaps, and valves. Vascular ultrasound, however, involves dynamic imaging of blood flow and relies on Doppler spectral analysis and pulsed Doppler. The combination of B-mode and Doppler is termed “duplex ultrasound.” Color-flow Doppler is an averaging process represented as red or blue color. This modality has significant advantages for assessing a vessel and is more technically demanding than B-mode imaging alone.