Program Book - Keck School of Medicine of USC - University of ...

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Incident counts &adjusted rates ofESRD, by HispanicethnicityUSRDS 2011 ADRIncident counts &adjusted rates ofESRD, by primarydiagnosisUSRDS 2011 ADRESRD-Mortality• Alive three years after thestart of ESRD therapy– Dialysis patients-50%– Pre-emptive transplant-82%• Adjusted rates of all-causemortality– 6.5-7.4 times greater fordialysis patients comparedwith general populationUSRDS 2011 ADR13
Adjusted all-cause & cause specificmortality (from day one) in thefirst year of hemodialysisUSRDS 2011 ADRAdjusted all-cause mortality in the ESRD& general populations, by age, 2009Adjusted survival probabilities,from day one, in the ESRD population14
Page 1 and 2: Program Book
Page 3 and 4: Needs AssessmentOver 370,000 patien
Page 5 and 6: ACKNOWLEDGEMENTSWe would like to th
Page 7 and 8: No relevant financial relationships
Page 9 and 10: 2:25 pm Vascular Access Infections,
Page 11 and 12: ESRD in 2012: Socio-economicImpactJ
Page 13: Geographic variations in adjustedin
Page 17 and 18: ESRD-International ComparisonsPreva
Page 19 and 20: Outcomes for first-time wait-listed
Page 21 and 22: NOTES______________________________
Page 23 and 24: Vascular Access Planning andPreoper
Page 25 and 26: • Veins not circular but ovoid, m
Page 27 and 28: VENOGRAM+ -CFDI+ 17(true positive)-
Page 29 and 30: • Thorough preoperative assessmen
Page 31 and 32: NOTES______________________________
Page 33 and 34: Options and Strategies forUpper Ext
Page 35 and 36: Cimino (radiocephalic) AVFPotential
Page 37 and 38: Two Stage BBAVFStage 1 anastomosis
Page 39 and 40: Brachial Artery-Brachial Vein AVFSu
Page 41 and 42: Forearm AV GraftsLarge surface area
Page 43 and 44: Comparison of brachial-basilic AVfi
Page 45 and 46: Racial differences in AVfistula rat
Page 47 and 48: THANK YOU!46
Page 49 and 50: Lower ExtremityDialysis AccessAhmed
Page 51 and 52: Lower Extremity Dialysis AccessWhat
Page 53 and 54: Lower Extremity Dialysis AccessData
Page 55 and 56: Lower Extremity Dialysis AccessData
Page 57 and 58: Thank You!LLUMC56
Page 59 and 60: NOTES______________________________
Page 61 and 62: NOTES______________________________
Page 63 and 64: When to Break the Guidelines in Vas
Page 65 and 66:
efore initiation of dialysis. It fu
Page 67 and 68:
NOTES______________________________
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Vascular AccessSurveillanceIs it wo
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Monitoring Vs. SurveillanceClinical
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Vascular Access Surveillance• Obs
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Vascular Access SurveillanceRandomi
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Vascular Access SurveillanceRandomi
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So why does preemptiveangioplasty n
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• ConclusionAccess Surveillance
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Management of the Non-MaturingArter
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Specific Definition• “…use of
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AVF Maturation in Clinical Practice
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Hemodialysis Fistula MaturationCons
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Physical Exam of AVF• Has an accu
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Significant Accessory VeinsSurgical
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Venous Stenosis in AVF Body/Outflow
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Deep or Excessively Tortuous AVF•
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Robert Hye, MD September 27, 2012Ka
Page 101 and 102:
Influence of Access Type onInfectio
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Prevention of HemodialysisAccess In
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Summary of CatheterManagement in CR
Page 107 and 108:
Partial versus Total GraftExcision
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Infected Autogenous DialysisFistula
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Ischemic Steal Syndrome due to Hemo
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Figure 2: (From JACS 2000: Wixon et
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Theoretically the presence of a lar
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Treatment of Ischemic Steal Syndrom
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performing a femoral-femoral bypass
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Ligation may still be an option for
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arterio-venous fistula. Acta Chir S
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David Shavelle, MD September 27, 20
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Definitions• Early (Primary) Fail
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Dual-Sheath TechniqueStep 1: Thromb
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Role of Stent Placement• Stenting
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ComplicationsPulmonary Embolism~10%
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PrePostMedical Therapy• Clopidogr
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Karen Woo, MD September 27, 2012Ass
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Dilation occurs over several years
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Replace with interposition graft◦
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Heparin Proximal and distal control
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144
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Perioperative variableOperative tim
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148
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POLICY ON CULTURAL AND LINGUISTIC C
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KECK SCHOOL OF MEDICINE OF THE UNIV
Page 155 and 156:
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