Dialysis Vascular Flashcards
good flow fistula
> 800 ml/min
typical fistula velocity
150-300 cm/sec PSV
60-200 cm/sec EDV
associated pseudoaneurysms
often multiple pedicle with to and fro pattern
early stenosis of fistula
500-800 ml/min
distal native artery
retrograde flow due to arterial steal from AVF
site of 80% stenosis/thrombosis of AVF
venous anastomosis
> 50% AVF stenosis at anastomosis
> 400 cm/sec
> 3.0 velocity ratio
visible narrowing
> 50 % AVF stenosis at venous anastomosis
PSV > 300 cm/sec velocity
ratio > 2.0
visible defect
valve,
narrowing,
intimal change
efferent vein velocity
30-100 cm/sec
pulsatile
rule of 6
6 mm wide
6 mm deep
6 weeks to mature
> 600 ml/min flow
evaluation prior to graft
exclude subclavian thrombosis exclude steal
volume flow
TAV (time average velocity) x area x 60 area =
(1/2 d)2/pi measure in straight area
vein diameters for mapping `
2-2.5 mm
common site of venous thrombosis with AV fistula
subclavian
understand afferent artery steal
compression reverses flow in afferent artery or compression makes waveforms look normal