648585
Beschreibung
Karteikarten von ecmarchese, aktualisiert more than 1 year ago
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Erstellt von ecmarchese
vor mehr als 10 Jahre
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| Frage | Antworten |
| Can duplex sonography be used to confirm the presence, location, and adequacy of a vein to be used for bypass? | Yes |
| True or false: Saphenous veins can be used as arterial conduit for CABG or LE bypass grafts? | True |
| Which can be used the greater or lesser sapheous vein for CABG or LE bypass grafts? | Both |
| Can the cephalic and basilic veins be used for bypass grafts? | Yes |
| What is the pre operative assessment of vein for harvesting? | determine suitability of vein to be harvested by assessing- if the saphenous vein is present, if the saphenous vein is patent, if it is continuous, any large varicosities, and the approx size |
| What should the size of the Saphenous vein measure? | 2.5 mm or greater |
| Why should you assess the deep system before vein harvesting? | The Saphenous could be feeding the deep system if compromised, and if that is so then it will not be removed. |
| What transducer do you use to assess the vein? | 7.5-10 MHz |
| What is the protocol for Duplex Assessment? | Bilateral study, evaluate deep system, CFV,SFV, POP compressibility. Then scan Saphenous in transverse measuring the diameter. Check for compressibility and look for irregularites |
| At what levels in the Duplex assessment do you measure the Saphenous vein diameter? | Groin, Proximal/mid/distal thigh, prox/ mid/ distal calf |
| What are the 3 thing you should look for in determining if the GSV is a single system? | Is there an accessory saphenous vein at the saphenofemoral junction, is there a bifid system when the GSV splits into two then reconnects in the distal thigh, are there any large branch varicose veins or large tributary veins |
| How much will the vein diameter expand when it is arterialized? | 80-100% |
| When is pre-op marking/ Mapping done? | Either the night before or the same day |
| What is the protocol for pre operative vein mapping? | Clean the area with alcohol, begin at saphenofemoral junction with vein in center or transducer and mark with pen |
| How does the leg need to be positioned in a vein mapping? | Dependent position |
| Where do you begin when you start your vein mapping? | Saphenofemoral junction |
| Where should the vein be in relation to the transducer? | Center |
| What do you do if the diameter of the GSV is less than 2.5mm? | mark with dotted line to let the surgeon aware |
| Should you mark larger perforators? | Yes, incisions at a perforator increases the healing time |
| What is another name for pre operative assessment of the radial artery? | Alans manuever |
| What is the Radial artery used for in harvesting? | CABG due to its long term patency |
| What are the advantages of harvesting radial arteries? | It is the appropriate tissue for CABG, thicker walls, less intimal hyperplasia, better availability |
| What are the contraindications for Radial Artery Harvesting? | iscehmic digits, Raynauds syndrome, ipsilateral athero occlusive disease in arm, sclerotic atresic or occluded artery, incomplete Palmer arch in hand |
| Which arm should the harvested artery come from? | Less dominant |
| What do you do to evaluate for Radial Artery Harvesting? | take bilateral brachial pressures to rule out subclavian artery stenosis, duplex or PPG or complete palmer arch |
| What do you do when performing at PPG? | place sensors on thumb or index finger and 5th digit, compress radial artery and observe and record changes. Repeat on ulnar artery |
| What does it mean during the PPG if the waveform flatlines during compression? | Arch is not intact |
| What do you do during duplex imaging of the radial artery? | identify origin of RA at the brachial artery and measure the diameter distally to the wrist |
| What are the average diameter of Distal RA for men? Women? | 2.8mm for men, 2.4 mm for women |
| Should imaging be performed on both radial and ulnar arteries? | Yes, to detect stenosis, occlusion, or atresia |
| Besides measurement, what should you do while evaluating the radial artery? | image and doppler artery. Flow should increase with compression of ulnar artery- repeat while compressing the radial |
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