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Related Concept Videos

Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
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Aneurysm IV: Nursing Management

Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
Cardiac Catheterization I: Pre-Procedure Overview01:28

Cardiac Catheterization I: Pre-Procedure Overview

Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
Cardiac Catheterization IV: Nursing Management01:26

Cardiac Catheterization IV: Nursing Management

Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
Pre-Procedural Guidelines for Assessing Blood Pressure01:10

Pre-Procedural Guidelines for Assessing Blood Pressure

Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the patient.
Imaging Studies VII: Vascular Imaging01:19

Imaging Studies VII: Vascular Imaging

DefinitionRenal angiography, also known as renal arteriography, is an imaging technique used to obtain a comprehensive view of blood flow and the vascular structure of blood vessels in the kidneys and surrounding areas.PurposeRenal angiography detects blood vessel abnormalities in the kidneys, such as aneurysms, stenosis, thrombosis, vascular tumors, and renal artery stenosis. It evaluates kidney function and guides interventional treatments like angioplasty or stent placement.Pre-Procedure...

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Related Experiment Video

Updated: Jun 23, 2026

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
06:04

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation

Published on: August 8, 2025

Preoperative evaluation for vascular access creation.

George Lampropoulos1, Spyros Papadoulas, George Katsimperis

  • 1Vascular Surgery Unit, Department of Surgery, Division of Hematology, University of Patra, Rio, Greece.

Vascular
|May 12, 2009
PubMed
Summary
This summary is machine-generated.

Ultrasound vessel mapping (USVM) significantly altered arteriovenous access plans in chronic kidney disease patients, especially diabetics. Selective upper extremity venography (UEV) is recommended for those with central venous catheter history.

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Area of Science:

  • Nephrology
  • Vascular Surgery
  • Radiology

Background:

  • Increasing arteriovenous fistula (AVF) prevalence is crucial for hemodialysis access.
  • The combined effectiveness of ultrasound vessel mapping (USVM) and upper extremity venography (UEV) for AV access planning is not well-established.
  • Physical examination alone may not adequately identify all vascular pathologies affecting AV access type.

Purpose of the Study:

  • To evaluate the impact of a combined USVM and UEV protocol on arteriovenous (AV) access type selection compared to physical examination alone in chronic kidney disease (CKD) patients.
  • To identify patient subgroups who benefit most from USVM and UEV in AV access planning.

Main Methods:

  • A prospective study of 137 CKD patients undergoing initial AV access planning based on physical examination.
  • Subsequent USVM and UEV were performed to detect vascular pathology that could alter the planned access type.
  • Comparison of planned vs. actual AV access type, with analysis of factors influencing changes.

Main Results:

  • USVM altered the preoperative AV access plan in 22.6% of patients, with a higher rate in diabetics (36.7%) compared to nondiabetics (14.8%).
  • Patients requiring plan alteration due to USVM had longer hemodialysis durations (2.7 vs. 0.9 years).
  • Venography identified central vein stenosis in 18 patients, leading to site changes in 12; stenosis was significantly higher in patients with prior central catheter placement (93% vs. 1%).
  • Overall, 31% of AV access plans were revised, with similar revision rates across distal AVF, central AVF, and AV grafts.
  • The 30-day patency rate was 92.2%.

Conclusions:

  • A significant proportion of CKD patients exhibit vascular pathology necessitating AV access type alteration beyond physical examination findings.
  • Routine USVM is recommended for comprehensive AV access planning.
  • UEV should be selectively employed in patients with a history of central vein surgery or instrumentation.