Which PSV and EDV thresholds indicate flow-reducing stenosis in the celiac artery?

• A. PSV > 250 cm/sec and EDV > 60 cm/sec with >50% stenosis
• B. PSV > 200 cm/sec and EDV > 55 cm/sec with >60% stenosis
• C. PSV > 180 cm/sec and EDV > 40 cm/sec with >70% stenosis
• D. PSV > 230 cm/sec and EDV > 50 cm/sec with >65% stenosis

Answer: (B)

Flow-reducing celiac stenosis is best suggested by Doppler velocity criteria that pair a higher peak systolic velocity with an elevated end-diastolic velocity, reflecting significant narrowing. The commonly used threshold is PSV around 200 cm/s or greater together with an EDV around 55 cm/s or greater, which corresponds to roughly 60% or more luminal stenosis. This combination best matches hemodynamically significant narrowing in the celiac artery.

Other sets of thresholds either require velocities that are too high or too low for the typical degree of stenosis, or set the percent stenosis inconsistent with the velocity pattern. Therefore the combination of PSV >200 cm/s and EDV >55 cm/s with >60% stenosis is the most reliable indicator of flow-reducing celiac artery stenosis.