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14 Cards in this Set
- Front
- Back
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Synthetic graft |
polythtrafluorethylene (PTFE) |
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Reversed saphenous vein graft |
saphenous vein is reversed prior to anastomosis to the prox and distal portions of the artery (small end of vein to prox segment of artery, larger end of vein to distal segment of artery); once vein is connected to artery it becomes arterialized, vein size becomes more consistent (no larger or smaller end); venous valves not disrupted because arterial flow forces them to stay open |
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In situ vein graft |
GSV is left in place with prox and distal ends anastomosed to the required artery segments
will have problem with valve and AVF |
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AV Fistula |
abnormal connection between an artery and a vein
can be due to trauma, surgical complication, inflammation, tumor invasion or congenital
surgically created for dialysis treatment
venous flow is pulsatile, increased arterial flow proximal to fistula, arterial flow distal to fistula is reduced
palpable thrill and bruit is detected in acquired AV fistula
Congenital CA stenosis if the contralateral pulse is normal fistula associate with varicose veins but do not have thrill or bruit |
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Brescia-Cimino fistula |
created between radial artery and cephalic vein
placement in nondominant arm
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Grafts and fistula criteria |
should have very high PSV ranging 100-400 cm/s; diastolic velocities high ranging 60-200 cm/s
low resistance waveform
fistula: PSV >250 cm/s = >50% fistula stenosis
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Graft stenosis criteria |
50-99% velocity increase = moderate stenosis >100% velocity increase = severe stenosis total occlusion = no flow detected
Flow volumes: Normal = 300-1000 ml/min Poor dialysis/graft failure = <250 ml/min CHF = >1200 ml/min |
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An abnormal flow rate for a radial artery/cephalic vein dialysis fistula is? |
less than 200 ml/min
a flow rate of around 00 ml/min is required for dialysis |
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An abnormal flow rate for a radial artery/cephalic vein dialysis fistula is? |
less than 200 ml/min
a flow rate of around 300 ml/min is required for dialysis |
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Digital/brachial systolic pressure ratio (BP) in an extremity with a dialysis fistula should ? |
not be measured; use contralateral arm |
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A traumatic arteriovenous fistula produces? |
high, pulsatile venous flow in the veins proximal to the fistula |
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Common abnormalities of dialysis fistula (synthetic or native) |
-stenosis at the venous anastomosis -aneurysm of the graft -false anuerys caused by needle puncture -spontaneous thrombosis |
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Severe dialysis access graft stenosis is dianosed when velocity ration measurements are? |
>100% velocity increase |
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Normal waveform for dialysis fistula? |
increased velocity low resistance high diastolic waveform |
