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| #1 cause of graft failure: | Outflow bed disease
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| 3 Treatments for graft failure: | 1. Angioplasty
2. Thrombectomy
3. Repeat Graft placement
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| 7 Graft Surveillance Characteristics towatch for: | 1. Stenosis
2. Wall irregularity
3. Aneurysms
4. Pseudoaneurysm (graft blow out)
5. AV fistulas from non-ligated perforators
6. Partially excised valve leaflets
7. Neointimal hyperplasia
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| 7 Above Inguinal Ligament Grafts: | 1. Aorto-bifemoral
2. Femoral to femoral “jump”
3. Axillo-femoral
4. Ilio-femoral
5. Axillary-axillary
6. Carotid-carotid bypass
7. Aortic bypass
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| 5 Contraindications for Radial Artery Harvest: | 1. Ischemic digits
2. Raynaud’s syndrome
3. Ipsilateral athero-occlusive disease in arm
4. Sclerotic, atresic, or occluded artery
5. Incomplete palmar arch in hand
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| 3 Advantages of Radial Artery Harvest: | 1. Appropriate arterial tissue for CABG
2. Thicker walls, less intimal hyperplasia
3. Better availability
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| To determine suitability, scan entire length of GSV in transverse plane using _______ MHz transducer | 7.5-10MHz
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| Normal Grafts/Fistulas have _____ systolic velocities: ____-____cm/s | *High systolic velocities – 100-400 cm/s
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| Normal Grafts/Fistulas have _____ diastolic velocities: ____-____cm/s | *High diastolic velocities – 60-200 cm/s
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| For hemodialysis Graft Evaluation, Document with 2D & Doppler (in the following order): | 1. Native inflow artery
2. Arterial anastomosis
3. Body of graft (prox, mid, distal)
4. Venous anastomosis
5. Native outflow vein
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| for Hemodialysis Grafts, Arterial inflow proximal to graft/fistula should demonstrate __________ waveforms | low resistant
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| for Hemodialysis Grafts, Arterial flow distal to anastomosis should be _______ and have a ___________ waveform | antegrade, high resistant
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| stenosis in the efferent vein is usually caused by: | neo-intimal hyperplasia
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| Criteria for dialysis Fistula stenosis: | PSV >250 cm/s + >50% stenosis
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| Criteria for dialysis GRAFT stenosis: |
*Mild – velocity increase <50% of preceding segment
*Moderate – velocity increase between 50-99% of preceding segment
*Severe – velocity increase >100% of preceding segment with a 50 % drop distally
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| Gold standard of grafts: | Reversed vein graft
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| 4 Below Inguinal Ligament Grafts: | 1. Synthetic (PTFE) graft
2. Reversed vein graft (Gold standard of grafts)
3. In situ fem-pop or fem-tibial graft
4. Femoral-infrapopliteal
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