Chap 84 86 Acquired AVF and Spine exposure Flashcards Preview

Vascular Surgery > Chap 84 86 Acquired AVF and Spine exposure > Flashcards

Flashcards in Chap 84 86 Acquired AVF and Spine exposure Deck (13):
1

What incision best for T3-T6?
T7-12

right thoracotomy
left thoracotomy

2

What are different approaches to the lumbosacral spine?

Transperitoneal exposure
Transperitoneal laparoscopic
Retroperitoneal

3

What are different methods of acquiring an AVF?

traumatic
iatrogenic
spontaneously

4

What is the natural hx of an iatrogenic AVF?

shunt volumes <500
50% close spon
usually benign

5

List disease associated with spontaneous AVF.

aneurysm
syphillis
HIV
CTD

6

What are the aAVF connection for carotid and vert?

to internal jugular

7

What are RF for femoral aAVF?

Older age
Female
Htn
Anticoagulation
Higher dose heparin
Warfarin
Left sided puncture
Multiple puncture
Low puncture
Large sheath
High BMI

8

What anatomical parameters determine flow in the distal artery?

CSA of fistula =/< then 1.5 d of inflow artery then distal flow in artery maintained

flow diminished or reversed if opening threefold size of artery

prox flow increase by x5 if 3

9

What are changes to vessels in chronic aAVF?

Proximally artery elongates
Artery thins ultimately leading to aneurismal degen
Proximal vein enlarges and becomes tortuous
Distal artery flow often reversed
Venous collateral
Reversible if repaired within 2 years

10

What are cath findings with large aAVF?

increased CO
elevated RA, RV, wedge P
decease in PVR

11

What are findings on duplex for aAVF?

Fistilous connection
Clor mosaic at level of fistula
Color pixels in adjacent soft tissue
Loss of triphasic wave forms in prox artery
Decreased flow in distal artery
Continuous high velocity flow in vein cephalad

12

What are findings of aAVF on angio?

Early venous filling
Failure of distal vessels to opacify

13

What are treatment strategies?

conservative for 1 year, indefinitely if really small and no sequallae

US guided compression --poor success rate

endovascular
embolization
covered stent
aortic endografts

surgery