What is the significance of a triphasic and biphasic waveform on arterial Doppler (Doppler Ultrasound) ultrasound of the lower extremities?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: April 9, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

The presence of a triphasic waveform on arterial Doppler ultrasound of the lower extremities is indicative of healthy, unobstructed arteries with good elasticity, whereas a biphasic waveform suggests mild to moderate arterial disease or increased peripheral resistance. When evaluating lower extremity arterial health, it is essential to consider the different blood flow patterns represented by triphasic and biphasic waveforms. A triphasic waveform consists of three phases: rapid forward flow during systole, brief flow reversal in early diastole, and slow forward flow in late diastole, indicating healthy arteries 1. On the other hand, a biphasic waveform shows only two components: forward flow during systole and forward flow during diastole, with loss of the reversal phase, suggesting mild to moderate arterial disease or increased peripheral resistance. The progression from triphasic to biphasic waveforms often indicates developing peripheral arterial disease (PAD), with the loss of the reversal component occurring when arterial compliance decreases due to atherosclerosis or other vascular pathologies 1. Key points to consider when evaluating these waveforms include:

  • The transition from triphasic to biphasic waveforms should prompt consideration of risk factors for PAD such as diabetes, smoking, hypertension, and hyperlipidemia.
  • Further deterioration to monophasic waveforms would indicate more severe disease requiring additional evaluation and possible intervention.
  • The use of standardized nomenclature for Doppler waveforms from lower extremity arteries has recently been proposed, highlighting the importance of accurate interpretation of these waveforms 1.
  • Additional perfusion assessments, including toe pressure/TBI, TcPO2, and SPP, can be used to assess local perfusion and determine wound-healing potential and risk for amputation in patients with nonhealing lower extremity wounds 1.

From the Research

Triphasic Biphasic Waveform on Arterial Doppler Ultrasound of Lower Extremities

  • There are no research papers to assist in answering this question, as the provided study 2 discusses the role of LSD1 in pro-inflammatory polarization of macrophages and its potential as an immunosuppressive drug, which is not directly related to triphasic biphasic waveform on arterial Doppler ultrasound of lower extremities.
  • The study 2 focuses on the molecular mechanisms of macrophage polarization and the potential therapeutic applications of LSD1 inhibitors, but does not provide any information on arterial Doppler ultrasound or waveform analysis.
  • Therefore, it is not possible to provide a detailed explanation or analysis of triphasic biphasic waveform on arterial Doppler ultrasound of lower extremities based on the provided evidence.

References

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.