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

Vascular UltrasonographyPrior to Dialysis Access Surgery• Arterial and venous duplex studies prior toaccess placement• 47 patients• 52% had at least one prior access• Venous occlusions and arterial lesions (forearmportion of radial artery)• Post US: 97% fistula formation rateAm J Surg 2002;184:568www.surgery.usc.eduNoninvasive criteria for selection of upperextremity arteries and veins for dialysis accessproceduresVenous ExaminationVenous luminal diameter 2.5 mm for AFVenous luminal diameter 4.0 mm for BGAbsence of segmental stenoses or occluded segmentsContinuity with the deep venous system in the upper armAbsence of ipsilateral central venous stenosis or occlusionArterial ExaminationAbsence of pressure differential 20 mm Hg between armsArterial lumen diameter 2.0 mmPatent palmar archSilva J Vasc Surg 1998;27:302-8www.surgery.usc.eduVenography• Excellent forproximal veins• Invasive• Contrast agent• More expensive• Redo access• Exhausted accesswww.surgery.usc.edu25