Vascular insufficiency from AV fistula - Revision history

ClaireLewis at 23:17, 17 October 2019

2019-10-17T23:17:20Z

← Older revision		Revision as of 23:17, 17 October 2019
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	==Differential Diagnosis==		==Differential Diagnosis==
	{{AV shunt complications DDX}}		{{AV shunt complications DDX}}
			{{Blue digit DDX}}

	==Evaluation==		==Evaluation==
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	*Confirmation by<ref>Rutherford RB. The value of noninvasive testing before and after hemodialysis access in the prevention and management of complications. Semin Vasc Surg. 1997; 10:157–161.</ref>:		*Confirmation by<ref>Rutherford RB. The value of noninvasive testing before and after hemodialysis access in the prevention and management of complications. Semin Vasc Surg. 1997; 10:157–161.</ref>:
	**Digital blood pressure measurement		**Digital blood pressure measurement
	**Duplex ultrasonography		**Duplex [[ultrasonography]]
	**Transcutaneous PO2 measurement		**Transcutaneous PO2 measurement

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	[[Category:Renal]]		[[Category:Renal]]
	[[Category:Vascular]]		[[Category:Vascular]]
			[[Category:Surgery]]

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-27T04:46:20Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 04:46, 27 July 2016
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	{{AV shunt complications DDX}}		{{AV shunt complications DDX}}

	==~~Diagnosis~~==		==Evaluation==
	*Initial diagnosis is clinical		*Initial diagnosis is clinical
	*Confirmation by<ref>Rutherford RB. The value of noninvasive testing before and after hemodialysis access in the prevention and management of complications. Semin Vasc Surg. 1997; 10:157–161.</ref>:		*Confirmation by<ref>Rutherford RB. The value of noninvasive testing before and after hemodialysis access in the prevention and management of complications. Semin Vasc Surg. 1997; 10:157–161.</ref>:

Ostermayer: Text replacement - "Category:Nephro" to "Category:Renal"

2016-03-22T14:08:24Z

Text replacement - "Category:Nephro" to "Category:Renal"

← Older revision		Revision as of 14:08, 22 March 2016
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	<references/>		<references/>

	[[Category:~~Nephro~~]]		[[Category:Renal]]
	[[Category:Vascular]]		[[Category:Vascular]]

Neil.m.young at 14:42, 18 October 2015

2015-10-18T14:42:27Z

← Older revision		Revision as of 14:42, 18 October 2015
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	{{AV shunt complications DDX}}		{{AV shunt complications DDX}}

	==~~Workup~~==		==Diagnosis==
	*Initial diagnosis is clinical		*Initial diagnosis is clinical
	*Confirmation by<ref>Rutherford RB. The value of noninvasive testing before and after hemodialysis access in the prevention and management of complications. Semin Vasc Surg. 1997; 10:157–161.</ref>:		*Confirmation by<ref>Rutherford RB. The value of noninvasive testing before and after hemodialysis access in the prevention and management of complications. Semin Vasc Surg. 1997; 10:157–161.</ref>:

Neil.m.young at 14:42, 18 October 2015

2015-10-18T14:42:05Z

← Older revision		Revision as of 14:42, 18 October 2015
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	==External Links==		==External Links==

	==~~Sources~~==		==References==
	<references/>		<references/>

	[[Category:Nephro]]		[[Category:Nephro]]
			[[Category:Vascular]]

Neil.m.young at 17:56, 13 March 2015

2015-03-13T17:56:02Z

← Older revision		Revision as of 17:56, 13 March 2015
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	==Background==		==Background==
	*Steal syndrome = Distal hypoperfusion ischemic syndrome		Steal syndrome = Distal hypoperfusion ischemic syndrome<ref>Malik et Al. Understanding the dialysis access steal syndrome. A review of the etiologies, diagnosis, prevention and treatment strategies. J Vasc Access. 2008 Jul-Sep;9(3):155-66.</ref>
	*Higher risk with more proximal fistulas<ref>Tordoir JHM, et al. Upper extremity ischemia and hemodialysis vascular access. European journal of vascular and endovascular surgery. 2004. 27(1):1-5.</ref>		*Higher risk with more proximal fistulas<ref>Tordoir JHM, et al. Upper extremity ischemia and hemodialysis vascular access. European journal of vascular and endovascular surgery. 2004. 27(1):1-5.</ref>
	**10–25% of brachiocephalic and basilic artery fistulas		**10–25% of brachiocephalic and basilic artery fistulas
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	**1–1.8% of radiocephalic fistulas		**1–1.8% of radiocephalic fistulas
	*Classically elderly woman with DM		*Classically elderly woman with DM
			*Patietn history may include revascularization or banding efforts that re-stenose

	==Clinical Features==		==Clinical Features==

Neil.m.young: ref added

2015-03-13T17:49:45Z

ref added

← Older revision		Revision as of 17:49, 13 March 2015
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	==Background==		==Background==
	Steal syndrome = Distal hypoperfusion ischemic syndrome<ref>Malik et Al. ~~Understanding the dialysis~~ access ~~steal syndrome~~. ~~A review~~ of ~~the etiologies, diagnosis, prevention~~ and ~~treatment strategies~~. ~~J Vasc Access~~. ~~2008 Jul-Sep;9~~(3):~~155~~-66.</ref>		*Steal syndrome = Distal hypoperfusion ischemic syndrome
	*~~5-10~~% of ~~brachial~~ artery fistulas		*Higher risk with more proximal fistulas<ref>Tordoir JHM, et al. Upper extremity ischemia and hemodialysis vascular access. European journal of vascular and endovascular surgery. 2004. 27(1):1-5.</ref>
	*1% of ~~radial artery~~ fistulas		**10–25% of brachiocephalic and basilic artery fistulas
			**4.3–6% of forearm prosthetic implants
			**1–1.8% of radiocephalic fistulas
	*Classically elderly woman with DM		*Classically elderly woman with DM
	*Patietn history may include revascularization or banding efforts that re-stenose

	==Clinical Features==		==Clinical Features==
	*Distal extremity becomes ischemic due shunting of arterial blood to venous side		*Distal extremity becomes ischemic due shunting of arterial blood to venous side
	**Exercise pain, nonhealing ulcers, cool, pulseless digits		**Exercise pain, nonhealing ulcers, cool, pulseless digits
			*4 Stages
			**Stage I: pale/blue and/or cold hand without pain
			**Stage II: pain during exercise and/or hemodialysis
			**Stage III: rest pain
			**Stage IV: ulcers/necrosis/gangrene

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Workup==		==Workup==
	*~~Diagnosed~~ by ~~Doppler US or angiography~~		*Initial diagnosis is clinical
			*Confirmation by<ref>Rutherford RB. The value of noninvasive testing before and after hemodialysis access in the prevention and management of complications. Semin Vasc Surg. 1997; 10:157–161.</ref>:
			**Digital blood pressure measurement
			**Duplex ultrasonography
			**Transcutaneous PO2 measurement

	==Management==		==Management==
			*Percutaneous transluminal angioplasty (PTA)
	*Surgery		*Surgery

Rossdonaldson1 at 02:04, 12 March 2015

2015-03-12T02:04:15Z

← Older revision		Revision as of 02:04, 12 March 2015
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	==Background==		==Background==
	*Steal syndrome = Distal hypoperfusion ischemic syndrome		Steal syndrome = Distal hypoperfusion ischemic syndrome<ref>Malik et Al. Understanding the dialysis access steal syndrome. A review of the etiologies, diagnosis, prevention and treatment strategies. J Vasc Access. 2008 Jul-Sep;9(3):155-66.</ref>
	*5-10% of brachial artery fistulas		*5-10% of brachial artery fistulas
	*1% of radial artery fistulas		*1% of radial artery fistulas
	*Classically elderly woman with DM		*Classically elderly woman with DM
	*~~Pt hx~~ may include revascularization or banding efforts that ~~restenose~~		*Patietn history may include revascularization or banding efforts that re-stenose

	==Clinical Features==		==Clinical Features==
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	==Sources==		==Sources==
	<references/>		<references/>
	*Malik et Al. Understanding the dialysis access steal syndrome. A review of the etiologies, diagnosis, prevention and treatment strategies. J Vasc Access. 2008 Jul-Sep;9(3):155-66.
	[[Category:Nephro]]		[[Category:Nephro]]

Kxl328: /* Sources */

2015-03-11T14:12:50Z

Sources

← Older revision		Revision as of 14:12, 11 March 2015
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	==Sources==		==Sources==
	<references/>		<references/>
			*Malik et Al. Understanding the dialysis access steal syndrome. A review of the etiologies, diagnosis, prevention and treatment strategies. J Vasc Access. 2008 Jul-Sep;9(3):155-66.
	[[Category:Nephro]]		[[Category:Nephro]]

Kxl328: /* Background */

2015-03-11T14:12:05Z

Background

← Older revision		Revision as of 14:12, 11 March 2015
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	*1% of radial artery fistulas		*1% of radial artery fistulas
	*Classically elderly woman with DM		*Classically elderly woman with DM
			*Pt hx may include revascularization or banding efforts that restenose

	==Clinical Features==		==Clinical Features==