Scissons, Bob wrote:
>
> Pat:
>
> You're talking about the basement when most of us only know the ground
> floor (for me, this translates into...arms are nice, legs--sorry, not
> that much experience).
>
> Very generally speaking, a significant lesion will usually cause a
> >100% increase in PSV when compared to the adjacent, normal segment.
>
> In Radiology, September 1998, Vol 208, #3, 655-661, Robbin et al use a
> focal 2 to 2.9 X PSV for 50-74% and a threefold increase for 75% and
> above, BUT, this was in the upper extremity.
>
> Other, UPPER extremity articles you might reference:
>
> Silva Berry's 1989, Journal of Vascular Technology, Vol 13, April
> 1989: "Hemodynamic flow parameters in grafts with adjunctive
> arteriovenous fistulas".
>
> Gerald Walter's 1992, Journal of Vascular Technology 16(3),
> May/June 1992: Color duplex evaluation of potential hemodialysis
> graft failure".
>
> Someone who might be able to help you in greater detail would be Carol
> Miranda, RVT, RDMS, RDCS.
>
> My lower extremity, synthetic loop, thigh access graft diagnosis of
> the month (a pre-Christmas holiday special by the way) is randomly
> pointing somewhere between "more or less" normal and "snow within 6
> months"...BUT...why does your vascular surgeon suspect a venous
> outflow obstruction (problems with dialysis--vascular surgeon
> intuition?).
>
> Hope this has been of some help.
>
> Bob Scissons
hi bob and thank you for your response. my surgeon's patient was
bleeding post dialysis and he suspected increase pressure in her graft
as a result of a venous obstruction.....we are still discussing it and
he will get a fistulagram for her.....glad to hear that your loop graft
is normal and even predicting the weather......clearly you received the
cream of the crop as far as grafts go......take care and happy holidays
to you and yours...........sincerely, pat powers, rvt