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it is calculated in a similar fashion but can be applied to any vessel, theoretically you could measure  a stroke volume in the cca prox to the graft, one in the graft and subtract for the residual volume going to the brain and then correlate with an additional volume measurement in the cca distal to the graft to see if it matches.  don't forget, 70% of the cca volume goes to the ica, 30% goes to the eca.  which brings up another question, will the ica steal from the eca and all your hair fall out?
 
the original question remains, can we document steal?  no.  there are to many collateral pathways for additional volume to come from.  It will still be a clinical diagnosis, do they get dizzy everytime they screw in a light bulb with that arm?  then they have a steal syndrome presentation.
 

...TJ

To handle yourself, use your head. To handle others, use your heart.


On Wed, May 5, 2010 at 3:09 PM, JASON r <[log in to unmask]> wrote:
TJ,
after giving this some thought, are you talking about the stroke volume produced and measured from the left ventricle? Has nothing to do with a Grafted or bypassed segement. But I see your logic and theory, which provokes further future inquiry.
 
j
 

Date: Wed, 5 May 2010 14:34:17 -0500

From: [log in to unmask]
Subject: Re: ICA steal from CCA to Subclavian bypass graft
To: [log in to unmask]

Jason,
 
stroke volume is calculated by the following  csa*vti.  where csa = crosectional area of the vessel,  vti = velocity time integral.
 
as i was saying it will give you the total flow in the carotid and the total flow in the graft simple math will tell you how much is left over to go to the brain.  this does not compensate for collateral, circle of willis, or any additional vertebral contribution to the cerebral circulation.  thats why the "steal" is a clinical diagnosis.
 
I had a patient once that had a cca to subclavian graft, an axillary to fem graft, a fem to fem graft and bilateral fem tib grafts.  his entire bilateral lower extremity circulation was fed by one common carotid.  he did not walk far before becoming syncopal.
 

...TJ

To handle yourself, use your head. To handle others, use your heart.


On Wed, May 5, 2010 at 12:08 PM, JASON r <[log in to unmask]> wrote:
what is a STROKE volume....? Is this the same as Graft Volume flow? And what is the correlation of stoke, and bypass grafts.....
Is there data on this... do you have the resource..
Curious
Jason
 

Date: Wed, 5 May 2010 11:25:55 -0500
From: [log in to unmask]

Subject: Re: ICA steal from CCA to Subclavian bypass graft
To: [log in to unmask]

calculate a stroke volume in the cca prox to the origin of the graft and a stroke volume in the graft, that will give you actual numbers for how much is being diverted.  the "steal" is a clinical diagnosis based on symptoms.
 

...TJ

To handle yourself, use your head. To handle others, use your heart.


On Wed, May 5, 2010 at 11:17 AM, Carla Stanley <[log in to unmask]> wrote:
Quick question:
Can you have a ICA steal from a CCA to subclavian artery bypass graft? If so how would you go about documenting it?

Carla Stanley, RVT
Comprehensive Vascular Care





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