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

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34Racial differences in AVfistula rates249 male patients– 95 African American (AA)Median age: 63 yearsCephalic Vein DiametersProximalupper armDistalupper armProximalforearmDistalforearmAfricanAmericanNon-AfricanAmericanP value2.6 2.8 0.12.4 3.0 0.022.0 2.5 0.031.7 2.1 0.0535Basilic Vein DiametersBasilicveindiameter(mm)Proximalupper armDistalupper armProximalforearmDistalforearmAfricanAmericanNon-AfricanAmericanP value3.5 4.0 0.0042.9 3.5 0.00021.8 2.5 < 0.00011.4 2.1 < 0.00013643
Racial differences in AVfistula ratesAVF– AA patients: 82%– Non-AA patients: 93%AVG– AA patients: 18%– Non-AA patients: 7%– P = 0.009Fistula Patency RatesOne yearPrimarypatencyPrimaryfunctionalpatencyAfricanAmerianNon-AficanAmericanP value80.8% 76.2% 0.473.1% 69.2% 0.538ConclusionsIf good vein and good artery– Radiocephalic 1 st choice– Brachio-cephalic 2 nd choice44
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 and 14: Geographic variations in adjustedin
Page 15 and 16: Adjusted all-cause & cause specific
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: Comparison of brachial-basilic AVfi
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______________________________
Page 69 and 70: Vascular AccessSurveillanceIs it wo
Page 71 and 72: Monitoring Vs. SurveillanceClinical
Page 73 and 74: Vascular Access Surveillance• Obs
Page 75 and 76: Vascular Access SurveillanceRandomi
Page 77 and 78: Vascular Access SurveillanceRandomi
Page 79 and 80: So why does preemptiveangioplasty n
Page 81 and 82: • ConclusionAccess Surveillance
Page 83 and 84: Management of the Non-MaturingArter
Page 85 and 86: Specific Definition• “…use of
Page 87 and 88: AVF Maturation in Clinical Practice
Page 89 and 90: Hemodialysis Fistula MaturationCons
Page 91 and 92: Physical Exam of AVF• Has an accu
Page 93 and 94: Significant Accessory VeinsSurgical
Page 95 and 96:
Venous Stenosis in AVF Body/Outflow
Page 97 and 98:
Deep or Excessively Tortuous AVF•
Page 99 and 100:
Robert Hye, MD September 27, 2012Ka
Page 101 and 102:
Influence of Access Type onInfectio
Page 103 and 104:
Prevention of HemodialysisAccess In
Page 105 and 106:
Summary of CatheterManagement in CR
Page 107 and 108:
Partial versus Total GraftExcision
Page 109 and 110:
Infected Autogenous DialysisFistula
Page 111 and 112:
Ischemic Steal Syndrome due to Hemo
Page 113 and 114:
Figure 2: (From JACS 2000: Wixon et
Page 115 and 116:
Theoretically the presence of a lar
Page 117 and 118:
Treatment of Ischemic Steal Syndrom
Page 119 and 120:
performing a femoral-femoral bypass
Page 121 and 122:
Ligation may still be an option for
Page 123 and 124:
arterio-venous fistula. Acta Chir S
Page 125 and 126:
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%
Page 135 and 136:
PrePostMedical Therapy• Clopidogr
Page 137 and 138:
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:
Page 157:
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