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11 Cards in this Set
- Front
- Back
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Pre-operative mapping |
• assess suitability of veins or arteries for: - in-situ femoral -distal bypass grafts -- saphenous vein • reversed femoro-popliteal bypass grafts -saphenous vein (cephalic and basilic veins) • coronary artery bypass graft (CABG) -radial artery • endoscopic perforator ligation • venous closure procedures |
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Possible vessels for harvest |
• greater saphenous vein • lesser saphenous vein • cephalic vein • basilica vein • radial artery |
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GSV |
• 10-13 valves (10-12 on exam) • Begins at medial malleolus Ends at CFV • 35% have bifid systems in thigh • Branch of GSV communicates with glacimini v in the thigh |
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LSV |
• posterior aspect of calf • drains into popliteal vein • communicates with GSV • "stocking seam vein" |
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Vein size |
• vein diameter will expand by 1.5 - 2 times when arterialized • vein diameters of >/= 2.5 mm have higher patency rates • veins < 2.5 mm have high failure rates |
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Pre-operative mapping for suitability |
• patient position: reverse trendelenberg or upper body elevated • transducer: 7.5-10 MHz linear |
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Other vessels for bypass |
• axillary vein • basilic vein • cephalic vein • median cubital vein |
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Scanning perforators |
• patient sitting, leg dependent • patient standing • scan fascia for "holes" |
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Perforators |
• disruption of facial plane by vein • vein coursing deep and connecting to deep system • perforators tend to be tortuous • skin depression can often be palpated over incompetent perforators |
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Radial artery harvest |
• May be harvested for use as a coronary artery bypass graft ---- Advantages: - appropriate caliber - thicker wall (less hyperplasia) - better availability |
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Pre-operative assessment |
• bilateral arm pressures - 20 mmHg gradient is significant - full digital evacuation using PVR with PPG - Allen test for palmar arch patency - duplex scan of radial artery |
