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If you can image the arterial flow below the access then you can actually see the stealing happen. Make sure you have the orientation correct, ie arterial above baseline, then image. The artery will have a reversed or partially reversed flow. Then compress the fistula and the waveform will revert back to completely antegrade. 
 
This is essentially the same as doing finger PPG. do a baseline, compress the fistula and evaluate waveform. Imaging is nice because it reduces some of the interpretation ambiguity that can happen during PPG's.
 

________________________________
 From: Jeff Stanley <[log in to unmask]>
To: [log in to unmask] 
Sent: Friday, September 19, 2014 11:45 AM
Subject: Steal
  


 
Good morning, 
  
Hope to steal some information from you regarding……..steal! 
  
Does anyone have specific diagnostic criteria for diagnosing steal from dialysis access grafts/fistulas?  Are you using finger PPG waveforms before and after access compression?  Finger pressures?  Radial/ulnar CW or PW waveforms pre- and post- access compression?  Are you looking to see if flow just increases to the hand with access compression, or are you measuring how much of a change there is in pressure or waveform amplitude and then determining whether there is a steal based on the change in flow? 
  
Thanks! 
  
Jeff 
  
   

Jeff Stanley BS, RVT 
Vascular Lab Manager
THE SURGICAL CLINIC, PLLC
356 24th Ave North, Suite 300
Nashville, TN 37203
Phone: 615.301.5261 | Fax: 615.320.3662
www.TSClinic.com


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