Arterial Duplex Following Intervention Flashcards
Anastomosis
The connection of the bypass graft to the artery
Bypass grafting
Used to route blood around the occluded segment
Synthetic grafts
Polytetrafluroethylene (PTFE) or Dacron
Autogenous vein
Uses the patients own vein or artery as a conduit
Describe In Situ Saphenous Vein Graft
Vein remains in normal anatomical position
Proximal and distal ends lighted and sutured into artery
Large end remains proximal, small end remains distal
Vein valves are destroyed with a special instrument
Tributaries are ligated
Describe Reversed Saphenous Vein Graft
Vein is removed
Tributaries are ligated
Ends sutured into artery
Large end is now distal — often not evident over time
Vein valves stay open due to arterial pressure
limitations of Autogenous vein (where is a common site for stenosis for them)
Retained valves are a common site of stenosis
Most common sites of stenosis in grafts
Vein grafts - retained valves
Synthetic grafts - anastomoses
Endovascular Aneurysm Repair (EVAR)
A catheter is used to position a graft inside of the aneurysm expanded and then hooked into place with stents
Aneurysm is NOT removed but simply excluded from the main artery
Most commonly performed for AAA but is also used for peripheral artery aneurysms
Endoleak
Flow within the aneurysm sac outside the graft wall
Why is it important to measure size of aneurysm sac, post surgery
Over time, the size of the aneurysm sac should decrease, an enlarging sac indicates potential endoleak
Endoleak type 1
Leak from the attachment site
1a - proximal
1b - distal
Endoleak type II
Patent branch with retrograde flow into the aneurysm (lumbar or IMA)
Endoleak III
Graft defect
Endoleak Type IV
Graft porosity, flow through the wall of the material
