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Read e-book online Arteriovenous Access Surgery: Ensuring Adequate Vascular PDF

By Hans Scholz

This publication bargains a entire review of updated wisdom on vascular entry surgical procedure. Written by means of a senior writer with greater than 30 years of expertise and by means of professional individuals, it covers either surgical and theoretical features. the writer stocks his services in a hands-on method and provides his perspectives at the problems that each clinician could come across. many of the suggestions for vascular entry production are rigorously reviewed. targeted descriptions and various accompanying illustrations of AV fistulas, AV prosthetic grafts, and arterio arterial grafts are supplied, and a bankruptcy is usually dedicated to using vital venous catheters. strength problems and their administration are defined, and suggestion is obtainable on tips to care for targeted sufferer teams requiring additional consciousness. Separate chapters on fluid dynamics (drawing at the author’s personal examine) and vascular pathology cater for the desires of these with a selected curiosity within the pathophysiological ideas.

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24). Proximal Basilic Fistula Indication/prerequisites Unsuitable cephalic vein but suitable basilic vein and suitable ulnar artery in the forearm. Prognosis Good long term results despite expressed tendency of the basilic vein to dilate more than desired. Approach (Fig. 25) Same procedure as with the distal basilic fistula. It is important to note the considerably deeper and more medial position of the ulnar artery between the two heads of the flexor carpi ulnaris muscle. In rare cases the radial artery can be used to feed the basilic vein (Fig.

In these cases a transposition of the vein is necessary. 3 32 AV Fistulas Fig. 56 Subcutaneous superficialization of an arterialized cephalic vein in an obese patient Diagnostics To evaluate the venous morphology, color-coded duplex sonography and phlebography are recommended if appropriate. Indication/prerequisites Difficult puncturability due to a position of the vein far beneath the surface, and also satisfactory venous diameter. Approach Total exposure of the vein over its total length in the forearm through mostly two to three skin incisions.

33), or a graft is implanted to re-establish vascular continuity (Fig. 34). Venous Stenosis of Forearm AV Fistula Possible causes are intraluminal tissue proliferation resulting from hemodynamic changes, inflammatory shrinking of the lumen (frequently after chemotherapy or IV drug abuse), or kinking (Fig. 35). The latter goes together with the (desired) dilation of the vein. Diagnosis To palpate a superficially-running vein over its entire length is frequently sufficient for its evaluation. This proves more difficult if the vein runs further beneath the surface.

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