Grafts Flashcards
What is a miller cuff?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/284/658/889/a_image_thumb.png?1532041550)
What is a taylor patch?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/284/658/890/a_image_thumb.png?1532041644)
What are disadvantages of miller cuff?
Turbulence
![](https://s3.amazonaws.com/brainscape-prod/system/cm/284/658/891/a_image_thumb.png?1532042285)
What are disadvantages of Taylor patch?
Lose venous endothelium on half anastomosis and need a lot of vein
![](https://s3.amazonaws.com/brainscape-prod/system/cm/284/658/892/a_image_thumb.png?1532042186)
What is a distal vein patch?
Venous patch, prosthetic anast to it
![](https://s3.amazonaws.com/brainscape-prod/system/cm/284/658/893/a_image_thumb.png?1532042412)
If you can’t use vein for tibial bypass, what is the best alternative?
Heparin bonded ePTFE - some recent studies shows noninferiority
![](https://s3.amazonaws.com/brainscape-prod/system/cm/284/658/894/a_image_thumb.png?1532042699)
Which graft theoretically promotes lateral flow to decrease shear and decrease adhesion molecules/intimal hyperplasia?
Spiral flow graft
![](https://s3.amazonaws.com/brainscape-prod/system/cm/284/658/895/a_image_thumb.png?1532042983)
What graft technique is available for poor arterial runoff
“Patchula” AV fistula to decrease outflow resistance
![](https://s3.amazonaws.com/brainscape-prod/system/cm/284/658/896/a_image_thumb.png?1532043180)
Is there any benefit to dual antiplatelet therapy for peripheral bypass?
CASPAR trial - maybe benefit in prosthetic grafts. ASA of benefit in prosthetic grafts based on Cochrane review
How often should you survey peripheral bypass grafts?
3, 6 months then annually
What is the Bandyk criteria for graft stenosis?
PSV > 300. Ratio > 3.5
How low of a velocity predicts mid graft failure?
< 45 cm/s
What causes early (< 6 months) graft failures?
Technical - poor inflow/outflow, thrombophilia
When do grafts fail due to myointimal hyperplasia?
Mid term - 6-24 months
When do grafts fail due to progression of disease?
Late, > 24 months
What is more effective for graft occlusions - thrombolysis or thrombectomy?
< 2 weeks of symptoms - thrombolysis, > 2 weeks - thrombectomy. STILE and TOPAS trials
What are 4 contraindications to thrombolysis?
- Recent surgery
- Non viable limb
- Bleeding disorders
- Hemorhagic stroke
What are 4 CT findings consistent with graft infection?
- Peri graft air
- Peri graft fluid
- Pseudoaneurysm
- Soft tissue attenuation
Which types of graft infection organisms mandate removal?
Pseudomonas, MRSA
Which procedure has the highest incidence of graft infection?
Ax-fem (5-8%)