French gauge

The French gauge (Fr) (also known as the French scale or system) is used to
size catheters, and other instruments, in interventional radiology and surgery.
In some parts of the world, the Charrière (Ch) is used as the name of the unit,
in honor of its inventor.

French sizing
The French system is simple, one increment on the French scale is equal to 1/3
millimeter, e.g. 8 Fr catheter is 8 x 0.33 mm = 2.67 mm in caliber.

Unlike the needle gauge system, the French system has no set lower or upper
limit, and users generally find it a lot less confusing, as the French size is
proportional to the diameter.

Some common French sizes with equivalent metric diameter and

circumferences:

• 3 Fr is 1 mm (diameter) and 3.14 mm (circumference)

• 4 Fr is 1.33 mm and 4.19 mm Frensh systems used for cannulation
with catheters and calibration.
• 5 Fr is 1.67 mm and 5.24 mm
• 6 Fr is 2 mm and 6.28 mm
Outer diameter = Vessel wall.
• 7 Fr is 2.33 mm and 7.33 mm
• 8 Fr is 2.67 mm and 8.34 mm
Guage System used for injection
• 9 Fr is 3 mm and 9.42 mm
Angiography contrast dyes. Puncture
• 10 Fr is 3.33 mm and 10.47 mm access sites. Insertion needle.

• 12 Fr is 4 mm and 12.57 mm Inner diameter.

• 14 Fr is 4.67 mm and 14.66 mm

• 16 Fr is 5.33 mm and 16.76 mm
• 20 Fr is 6.66 mm and 20.94 mm
French System outer diameter.

Guage System inner diameter.

1Fr.= 0.33 mm. = 3.4 atm. Pressure. (PSI)

MBP =maximal burst pressure.
Laplace law ; Pressure applied for Inflation § diameter Vessel
wall.
Reflects normal Blood Flow velocity and normal Artery Diameter.
 Artery Diameter Peak Sys.
Velocity
Normal Artery CFA 5mm - 9mm. 65-73 cm/sec
Diameter SFA 6mm 68-73cm/sec
POPLITEAL ARTERY 4-5 mm 57-72cm/sec
ATA 1mm-2mm 60-73cm/sec
PTA 1mm-2mm 70-77cm/sec
Peroneal a 1mm-2mm 64-76cm/sec
Proximal Aorta 22mm-40mm 161 cm/sec
Infra Renal AORTA 18mm- 32mm 55-67cm/sec
Common Carotid a. 6mm 40-50 cm/sec
Internal Carotid a. 4-6 mm 66-<125cm/sec
Common Iliac Artery 8mm –10mm 70+/-17cm/sec
Internal Iliac Artery 4mm
External Iliac Artery 7mm-9mm 115+/-20cm/sec
Subclavian artery 6mm 70-120cm/sec
Axillary a. 5mm 90-140cm/sec.
Brachiocephalic artery 9mm 70-120cm/sec.
Brachial artery 5mm 50-100 cm/sec
Radial artery 1mm-2mm 40-90cm/sec.
Ulnar artery 1mm-3mm 40-90cm/sec.
Renal artery 4mm-7mm 112-91cm/sec.
Superior mesentric artery1mm-4mm 97–142 cm/sec
Inferior mesentric artery 2mm - 3mm 93–189 cm/sec

Celiac Artery 1mm - 3mm 98–105 cm/sec

External Carotid a. 83+/-17cm/sec.
Possielleau's law ; signifies 1.Stenoses which is resistance to Flow.
2.Poststenotic Dilatation reflects increased Flow velocity. Calculate
Blood Flow velocity and volume through resistance and Stenoses.
 Practical points

• Spectral broadening (ultrasound)

Last revised by Dr Yuranga Weerakkody◉ on 17 Aug 2021

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Citation, DOI & article data

Spectral broadening is an important artifact in pulsed wave

Doppler ultrasound imaging, due to its clinical relevance as a sign of vessel
stenosis.

Physics
Spectral broadening is caused by turbulence in blood flow as the normally
homogeneous velocity of reflective red blood cells becomes more diverse,
resulting in the apparent broadening of the spectral Doppler waveform.
Typically this results in a "fill-in" of the area between a curve and the baseline
due to varying velocity of reflectors in the sampling area. This is hallmark
feature of poststenotic flow, which is increasingly turbulent with the
progression of the narrowing. However, improper acquisition technique can
also result in spurious spectral broadening via a variety of ways 1.

Spectral broadening is a valuable sign in arterial Doppler imaging, e.g. in

the assessment of the carotids. It can signal the development of significant
stenosis in difficult situations where e.g. direct measurement in the most
stenotic areas is not possible due to circumferential atherosclerotic plaques
resulting in complete acoustic shadowing. Observing spectral waveform
broadening distal to this "black box" segment indirectly indicates significant
narrowing.

However, care must be taken to use a proper measurement technique in

order to avoid spurious broadening of the spectrum. Artifactual spectral
broadening is dependent on the angle of insonation and will increase as the
angle approaches 90°. Maintaining a proper orientation (<60°) of the
ultrasound beam can minimize this artifact 2. Care must be taken to use an
appropriately sized sample volume within the interrogated blood vessel. If the
sampling area is too wide, or too close to the vessel wall, the inclusion of
slower velocity flow along the vessel walls will result in spectral broadening,
which can be mistaken for poststenotic turbulence. A high pulsed wave
Doppler gain setting can also result in spectral broadening 1,3.
According to the literature review, the normal levels of flow velocities in visceral
vessels are as follows(3):

• celiac trunk: PSV – 98–105 cm/s;

• SMA: PSV – 97–142 cm/s;
• IMA: PSV – 93–189 cm/s.

Based on the observations of the celiac trunk performed by the authors on young,
slim patients without the arcuate ligament syndrome, PSV can reach levels up to 150
cm/s.
Given the standard stenosis recognition criteria of >70%, the increase in peak
systolic velocity (PSV) over 200 cm/s in the celiac trunk; of PSV > 275 cm/s in the
superior mesenteric artery, and of PSV > 250 cm/s in the inferior mesenteric artery,
the likelihood of correct diagnosis is above 90%. In the case of stenosis due to
compression of the celiac trunk by median arcuate ligament of the diaphragm, a
valuable addition to the regular examination procedure is to normalize the flow
velocity in the vessel, i.e. the reduction in peak systolic velocity levels below 200
cm/s, and in end-diastolic velocity (EDV) levels below 55 cm/s during deep
inspiration. In the case of celiac trunk stenosis exceeding 70–80%, additional
information on the level of collateral circulation can be obtained by measuring the
flow in the hepatic and splenic arteries –

•
 Ultrasound

Peak systolic End diastolic

Prox. Aorta 161 cm/s 33.0 cm/s

Right main renal artery 112 cm/s 38.6 cm/s

Left main renal artery 91.3 cm/s 35.9 cm/s

The renal/ aorta ratio (RAR) is within normal limits bilaterally; Right RAR = 0.70
while the Left RAR = 0.57. NB: each is <3.5 (normal).
Normal, angle-corrected peak systolic velocities (PSVs) within the proximal arm arteries, such as the
subclavian and axillary arteries, generally run between 70 and 120 cm/s. Brachial artery PSVs range from
50 to 100 cm/s. Velocities in normal radial and ulnar arteries range between 40 and 90 cm/s