open access

Vol 28, No 4 (2022)
Case report
Published online: 2022-12-30
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Standing waves in a patient with systemic scleroderma

Michał Piotr Wysocki1, Andrzej Szuba2, Jędrzej Fischer2
DOI: 10.5603/AA.2022.0017
·
Acta Angiologica 2022;28(4):171-174.
Affiliations
  1. Medical University in Wroclaw, Poland, Poland
  2. Department of Angiology, Hypertension and Diabetology, University Clinical Hospital in Wroclaw, Wroclaw, Poland

open access

Vol 28, No 4 (2022)
Case reports
Published online: 2022-12-30

Abstract

Standing waves are a very rare angiographic image with an unclear etiology. Many theories have been developed
to explain this phenomenon, but none have been confirmed. We present an interesting case of a 57-year-old
woman, whose angiography showed standing waves along the entire length of the superficial femoral artery.
On admission, the patient’s general condition was fairly good. No significant abnormalities were observed in the
P-A chest feet and hands X-ray, as well as in the ultrasound of the abdominal cavity and pelvis. On March 8,
the patient underwent angiography documenting the presence of regular “goose trachea-like” ‘notched walls’
over the entire length of the right superficial femoral artery. Angiography was then followed by an ultrasound
exam of femoral arteries, however, no femoral artery wall changes were seen. The diagnosis was standing
waves. Moreover, extensive diagnostics for systemic disease, as well as the overall clinical picture allowed for
the diagnosis of systemic scleroderma.
Standing waves are a rare phenomenon, harmless to the patient’s life and health. Researchers have put forward
many theories to explain its unclear etiology. The presence of standing waves has also been reported with
the coexistence of diseases such as Buerger’s, Tolos-Hunt’s, or rheumatic heart disease. Moreover, it is worth
mentioning the possibility of misdiagnosing standing waves as FMD.
To summarize, standing waves are a harmless phenomenon. Despite its rare occurrence, it is worth remembering
not to misdiagnose it and consequently, implement unnecessary diagnostics and treatment and cause
superfluous anxiety in the patient.

Abstract

Standing waves are a very rare angiographic image with an unclear etiology. Many theories have been developed
to explain this phenomenon, but none have been confirmed. We present an interesting case of a 57-year-old
woman, whose angiography showed standing waves along the entire length of the superficial femoral artery.
On admission, the patient’s general condition was fairly good. No significant abnormalities were observed in the
P-A chest feet and hands X-ray, as well as in the ultrasound of the abdominal cavity and pelvis. On March 8,
the patient underwent angiography documenting the presence of regular “goose trachea-like” ‘notched walls’
over the entire length of the right superficial femoral artery. Angiography was then followed by an ultrasound
exam of femoral arteries, however, no femoral artery wall changes were seen. The diagnosis was standing
waves. Moreover, extensive diagnostics for systemic disease, as well as the overall clinical picture allowed for
the diagnosis of systemic scleroderma.
Standing waves are a rare phenomenon, harmless to the patient’s life and health. Researchers have put forward
many theories to explain its unclear etiology. The presence of standing waves has also been reported with
the coexistence of diseases such as Buerger’s, Tolos-Hunt’s, or rheumatic heart disease. Moreover, it is worth
mentioning the possibility of misdiagnosing standing waves as FMD.
To summarize, standing waves are a harmless phenomenon. Despite its rare occurrence, it is worth remembering
not to misdiagnose it and consequently, implement unnecessary diagnostics and treatment and cause
superfluous anxiety in the patient.

Get Citation

Keywords

standing waves; angiography; ultrasonography; vascular disease; systemic scleroderma

About this article
Title

Standing waves in a patient with systemic scleroderma

Journal

Acta Angiologica

Issue

Vol 28, No 4 (2022)

Article type

Case report

Pages

171-174

Published online

2022-12-30

Page views

487

Article views/downloads

55

DOI

10.5603/AA.2022.0017

Bibliographic record

Acta Angiologica 2022;28(4):171-174.

Keywords

standing waves
angiography
ultrasonography
vascular disease
systemic scleroderma

Authors

Michał Piotr Wysocki
Andrzej Szuba
Jędrzej Fischer

References (10)
  1. Lehrer H. The physiology of angiographic arterial waves. Radiology. 1967; 89(1): 11–19.
  2. Jacobsen JC, Beierholm U, Mikkelsen R, et al. "Sausage-string" appearance of arteries and arterioles can be caused by an instability of the blood vessel wall. Am J Physiol Regul Integr Comp Physiol. 2002; 283(5): R1118–R1130.
  3. BARTLEY O, WICKBOM I, BARTLEY O, et al. Arterial spasm in peripheral arteriography using the catheter method. Acta radiol. 1957; 47(6): 433–448.
  4. Joseph JM, Doenz F, Mosimann F. ["Standing waves": differential diagnosis of fibromuscular dysplasia]. Helv Chir Acta. 1994; 60(6): 897–899.
  5. Rasheed A, White SB, Bhalla M. Standing Waves on Computed Tomography Angiography in Multiple Vessels in a Young Trauma Patient. J Comput Assist Tomogr. 2021; 45(2): 238–241.
  6. Peynircioglu B, Cil BE, Peynircioglu B, et al. Standing or stationary arterial waves of the superior mesenteric artery at MR angiography and subsequent conventional arteriography. J Vasc Interv Radiol. 2007; 18(10): 1329–1330.
  7. Kröger K, Massalha K. Sonographic correlate of stationary waves. J Clin Ultrasound. 2004; 32(3): 158–161.
  8. Kettler HL, Martin JD. Arterial stationary wave phenomenon in Tolosa-Hunt syndrome. Neurology. 1975; 25(8): 765–770.
  9. Steinberg I. Stationary waves of the superficial femoral arteries. Report of a case occurring in a patient with rheumatic heart disease and popliteal arterial emboli. Am J Roentgenol Radium Ther Nucl Med. 1966; 98(4): 901–906.
  10. Sharma AM, Gornik HL. Standing arterial waves is NOT fibromuscular dysplasia. Circ Cardiovasc Interv. 2012; 5(1): e9–ee11.

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