1.6 Hemodialysis Grafts & AV fistulas

Question 1

Significant stenosis appearance on spectral (4)

Answer 1

1. decreased spontaneity
2. decreased phasicity
3. abnormal pulsatility

Question 2

What is used more frequently to determine the severity of the Stenosis?
PSV’s or Peak systolic ratio (V2/V1)

Answer 2

Peak systolic ratio (V2/V1)

Question 3

Normal PSV RATIOat the distal anastomosis

Answer 3

< 3.0

Question 4

Volume Flow with optimal FISTULA graft performance? (mL/min)

Answer 4

> 500 mL/min

Question 5

In a high flow situation the blood flows from the _____ pressure artery to the ____ pressure vein

Answer 5

High;Low

Question 6

Arterial flow below the anastomosis is?

Answer 6

High resistance

Question 7

When is hemodialysis necessary?

Answer 7

End Stage Renal disease (ESRD)

Question 8

Which veins should be evaluated for stenosis?

Answer 8

SCV and Internal jugular

Question 9

What is the most common cause of failure of graft in the first month?

Answer 9

Thrombosis of the graft

Question 10

Normal PSV in the outflow vein in dialysis grafts

Answer 10

30-100cm/s

Question 11

What is Hemodialysis?

Answer 11

Removal of certain elements from the blood through a semi permeable membrane while being circulated outside the body

Question 12

What are grafts evaluated for? (6)

Answer 12

Stenosis
Thrombosis
Aneurysms
Pseudoaneurysms
hematomas
arterial steal from the hand

Question 13

When AVF is not an option and AV ____ can be used

Answer 13

Graft

Question 14

What depth from the skins surface is required for successful dialysis acess?

Answer 14

5mm

Question 15

A normal Hemodialysis waveform displays ____ flow, is ___ resistance and has______ PSV and EDV

Answer 15

High;Low;Increased

Question 16

Define STEAL syndrome

Answer 16

reversal of flow in the ulnar or radial artery

May indicate “stealing” due to low pressure upstream from the wrist (SEE PICTURES)

Question 17

Arterial flow above the anastomosis is?

Answer 17

Low resistance

Question 18

What is an AV fistula

Answer 18

connection of artery and vein

Question 19

Type of Grafts (2)

Answer 19

1. Straight graft

2. Loop Graft

Question 20

Significant stenosis appearance on color/greyscale (4)

Answer 20

1. Decreased lumen
2. color jet
3. increased velocities
4. post-stenotic turbulence

Question 21

What is an AV fistula trying to accomplish?

Answer 21

High flow situation

Question 22

AGAIN

Normal PSV for fistulas and grafts

Answer 22

<400 cm/s

Question 23

Normal PSV RATIO in the outflow vein & Dialysis grafts/fistulas

Answer 23

< 2.0

Question 24

Normal PSV for Dialysis Grafts

Answer 24

100-400 cm/s

Question 25

Volume flow for suboptimal graft performance

Answer 25

<800mL/min

Question 26

Volume flow for suboptimal fistula performance

Answer 26

<500mL/min

Question 27

Volume Flow with optimal dialysis graft performance? (mL/min)

Answer 27

> 800 mL/min

Question 28

In a venous anastomosis of a prosthetic graft a significant stenosis (>50%) has a PSV of

Answer 28

>400 cm/s

Question 29

In a venous anastomosis of a prosthetic graft a significant stenosis (>50%) has a PSV RATIO (V2/V1)

Answer 29

>/= 1.9

Question 30

AV graft used a_____ or _____ as a channel.

Answer 30

Prosthetic graft; Vein

Question 31

Normal EDV for Dialysis Grafts

Answer 31

60-200 cm/s

Question 32

AV ANASTOMOSIS significant stenosis (>50%) has a PSV RATIO (V2/V1)

Answer 32

> 3.0

Question 33

Hemodialysis required _____ flow in and easily accessed vessel that can tolerate multiple punctures with catheters

Answer 33

High

Question 34

Arterial inflow and venous outflow of a AV fistuala significant stenosis (>50%) has a PSV RATIO (V2/V1)

Answer 34

>2.0

Question 35

Types of Fistulas (2)

Answer 35

1. End to Side 2. Side to Side (cephalic to radial)