HD access

Question 1

where is the brachial artery in AC fossa

Answer 1

under the flexor retinaculum of brachioradialis muscle

Question 2

saphenous vein transposition patency rates

Answer 2

25% early failure

80% patency @1 year

Question 3

durability of central vein angioplasty

Answer 3

40% @ 6 months

Question 4

treatment for HD associated steal

Answer 4

1. banding
2. DRIL
3. RUDI (revision using distal inflow)
4. PAI
5. ligation

Question 5

how to evaluate for AVF stenosis

Answer 5

PSV @ anastomosis / PSV @ arterial side 2 cm cranial

Question 6

What PSV ration indicated >70% stenosis

Answer 6

> 3

Question 7

What’s Nicoladeni - Brankam sign

Answer 7

if you occlude an AVF, BP increases and HR decreases

Question 8

how to diagnose steal on studies:

Answer 8

increase >50% in velocity of distal artery and increase >50% in digit pressure altitude

Question 9

most common reason for early HD access thrombosis

Answer 9

venous outflow problem.

can be arterial and technical but venous outflow most common

Question 10

reason for late AVF thrombosis

Answer 10

stenosis of venous conduit

Question 11

reason for late AVG thrombosis

Answer 11

venous anastomosis stricture

Question 12

risk factors for steal developement

Answer 12

use of brachial artery, DM, female gender