AVF/AVG Monitoring and Examination (Applied Clinical Cases) - Dr. Gawad
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AVF/AVG Monitoring and Examination (Applied Clinical Cases) - Dr. Gawad
- 1. AVF/AVG Monitoring and Examination Applied Clinical Cases Mohammed Abdel Gawad Nephrology Consultant - Alexandria MD Nephrology - Mansoura University drgawad@gmail.com
- 4. Talk Outline • Dialysis access creation • Dialysis access physical examination • Case 1: AVF with poor maturation (Diagnosis) • Case 2: AVF with poor maturation (Management) • Case 3: Pain and numbness in access hand • Case 4: AVF banding indications • Case 5, 6: Secondary fistula "Sleeves Up” • Case 7: AVG infection • Case 8: AVF infection • Case 9: AVF aneurysm
- 5. Talk Outline • Dialysis access creation • Dialysis access physical examination • Case 1: AVF with poor maturation (Diagnosis) • Case 2: AVF with poor maturation (Management) • Case 3: Pain and numbness in access hand • Case 4: AVF banding indications • Case 5, 6: Secondary fistula "Sleeves Up” • Case 7: AVG infection • Case 8: AVF infection • Case 9: AVF aneurysm
- 7. Download this report and older reports from ERDS page at www.esnt-online.com
- 8. Talk Outline • Dialysis access creation • Dialysis access physical examination • Case 1: AVF with poor maturation (Diagnosis) • Case 2: AVF with poor maturation (Management) • Case 3: Pain and numbness in access hand • Case 4: AVF banding indications • Case 5, 6: Secondary fistula "Sleeves Up” • Case 7: AVG infection • Case 8: AVF infection • Case 9: AVF aneurysm
- 11. Inflow Outflow
- 15. Strong, Localized, Discontinues Thrill (Systolic only) 2020;75(4)(suppl 2):S1-S164
- 23. Talk Outline • Dialysis access creation • Dialysis access physical examination • Case 1: AVF with poor maturation (Diagnosis) • Case 2: AVF with poor maturation (Management) • Case 3: Pain and numbness in access hand • Case 4: AVF banding indications • Case 5, 6: Secondary fistula "Sleeves Up” • Case 7: AVG infection • Case 8: AVF infection • Case 9: AVF aneurysm
- 27. Talk Outline • Dialysis access creation • Dialysis access physical examination • Case 1: AVF with poor maturation (Diagnosis) • Case 2: AVF with poor maturation (Management) • Case 3: Pain and numbness in access hand • Case 4: AVF banding indications • Case 5, 6: Secondary fistula "Sleeves Up” • Case 7: AVG infection • Case 8: AVF infection • Case 9: AVF aneurysm
- 32. Palpation Pulse Augmentation Test Normally: Pulse augmentation, Absence of Thrill
- 33. Palpation Pulse Augmentation Test No Pulse augmentation Normally: Pulse augmentation, Absence of Thrill
- 34. Palpation Pulse Augmentation Test No Pulse augmentation, No thrill = Inflow stenosis No Pulse augmentation, Normal thrill = Accessory Vein(s) No Pulse augmentation
- 35. Talk Outline • Dialysis access creation • Dialysis access physical examination • Case 1: AVF with poor maturation (Diagnosis) • Case 2: AVF with poor maturation (Management) • Case 3: Pain and numbness in access hand • Case 4: AVF banding indications • Case 5, 6: Secondary fistula "Sleeves Up” • Case 7: AVG infection • Case 8: AVF infection • Case 9: AVF aneurysm
- 41. Talk Outline • Dialysis access creation • Dialysis access physical examination • Case 1: AVF with poor maturation (Diagnosis) • Case 2: AVF with poor maturation (Management) • Case 3: Pain and numbness in access hand • Case 4: AVF banding indications • Case 5, 6: Secondary fistula "Sleeves Up” • Case 7: AVG infection • Case 8: AVF infection • Case 9: AVF aneurysm
- 42. 2018 Dec; 1: 27 AVF banding for dialysis-access steal syndrome and high-output cardiac failure
- 44. Talk Outline • Dialysis access creation • Dialysis access physical examination • Case 1: AVF with poor maturation (Diagnosis) • Case 2: AVF with poor maturation (Management) • Case 3: Pain and numbness in access hand • Case 4: AVF banding indications • Case 5, 6: Secondary fistula "Sleeves Up” • Case 7: AVG infection • Case 8: AVF infection • Case 9: AVF aneurysm
- 48. 2010;9(3):173-176 A 69-year-old female patient had been in a hemodialysis program for 10 years presenting with thrombosis of a brachial- cephalic AVF. Basilic vein was used on the access repair, avoiding catheter use.
- 50. Talk Outline • Dialysis access creation • Dialysis access physical examination • Case 1: AVF with poor maturation (Diagnosis) • Case 2: AVF with poor maturation (Management) • Case 3: Pain and numbness in access hand • Case 4: AVF banding indications • Case 5, 6: Secondary fistula "Sleeves Up” • Case 7: AVG infection • Case 8: AVF infection • Case 9: AVF aneurysm
- 55. Talk Outline • Dialysis access creation • Dialysis access physical examination • Case 1: AVF with poor maturation (Diagnosis) • Case 2: AVF with poor maturation (Management) • Case 3: Pain and numbness in access hand • Case 4: AVF banding indications • Case 5, 6: Secondary fistula "Sleeves Up” • Case 7: AVG infection • Case 8: AVF infection • Case 9: AVF aneurysm
- 60. Talk Outline • Dialysis access creation • Dialysis access physical examination • Case 1: AVF with poor maturation (Diagnosis) • Case 2: AVF with poor maturation (Management) • Case 3: Pain and numbness in access hand • Case 4: AVF banding indications • Case 5, 6: Secondary fistula "Sleeves Up” • Case 7: AVG infection • Case 8: AVF infection • Case 9: AVF aneurysm
- 61. Received 3 January 2011; Revised 10 March 2011; Accepted 24 March 2011 Rupture of AVF No significant dialysis access issues were observed until two weeks before the current presentation when dialysis nurses observed aneurysmal dilatation of his AV fistula and recurrent prolonged bleeding from the cannulation site Angioplasty was again successfully performed Five months after this procedure, prolonged fistula bleeding after dialysis → AV fistulogram → recurrent stenosis Successful angioplasty → establishment of good fistula flow Fistulogram → two areas of venous stenosis and an aneurysmal dilatation in the proximal portion of the outflow vein