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A sonographer is evaluating a patient with a suspected Inter…

A sonographer is evaluating a patient with a suspected Internal Carotid Artery (ICA) occlusion. Using standard carotid settings (PRF 3.0 kHz, medium wall filter), no color or spectral flow is detected in the distal ICA. To rule out a “trickle flow” near-occlusion, which combination of machine adjustments must be made to maximize sensitivity for low-velocity blood flow?

A 68-year-old male with a history of hypertension, hyperlipi…

A 68-year-old male with a history of hypertension, hyperlipidemia, and smoking presents to the vascular lab for a carotid and upper extremity arterial duplex ultrasound. He reports a history of transient dizziness and weak pulses in his right arm.During the ultrasound evaluation, the sonographer notes the following spectral Doppler findings:Right Common Carotid Artery (CCA): A low-velocity, delayed systolic upstroke with a rounded peak (tardus-parvus waveform).Right Subclavian Artery: A low-velocity, monophasic, delayed upstroke (tardus-parvus waveform) distally.Left CCA and Left Subclavian Artery: Normal high-velocity upstrokes with sharp systolic peaks.where is the most likely site of arterial obstruction?