venous.invenous.in/presentationtalk/DR PRITEE SHARMA.pdf · Arterial inflow Venous outflow ....
Transcript of venous.invenous.in/presentationtalk/DR PRITEE SHARMA.pdf · Arterial inflow Venous outflow ....
DISASTER!!!!!
Functional AVF Attempted & Failed AVF
WHY AVF placements
Need for Grafts & catheters
AV access Functional
HOW
Duplex Ultrasound
• Linear Transducer
• 7.5 – 12 MHz
• Grey scale & Pulse Doppler
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LOOK FOR WHAT
Arterial inflow
Venous outflow
WHAT………..ARTERY
Grey scale:
• Internal luminal diameter
• Calcification
• High bifurcation of brachial artery
WHAT………..ARTERY
Internal Luminal Diameter (>0.20 cm)
Qαr4
*Silva MB et al J Vasc Surg (1998), 27: 302-8.
*Lockhart Me et al J Ultrasound Med (2004), 23:161-8.
RADIAL ARTERY RADIAL ARTERY
WHAT………..ARTERY
Pulsed Color Doppler:
• Arterial spectral waveforms
• Modified Allen test
• Peak systolic/end-diastolic velocities
• Resistivity index
WHAT………..ARTERY
Arterial spectral waveforms
Triphasic Flow
WHAT………..ARTERY
Modified Allen test
Reversal of blood flow distal to the proximal occlusion
WHAT………..VEIN
Depth of vein- Fat, fifty, female
Internal luminal diameter
Compressibility, phlebosclerosis
Site & length of stenosis
Respiratory variation of flow
WHAT………..VEIN Internal luminal diameter (AVF > 2.5mm, AVG >4 mm)
* Silva MB et al J Vasc Surg (1998), 27: 302-8.
CEPHALIC VEIN CEPHALIC VEIN
WHAT………..VEIN
WHAT………..VEIN
Respiratory variation
Normal Respiratory Variation Slow Antegrade flow
without Respiratory
Variation