Before initiation of hemodialysis, an unexpectedly high prevalence of critical stenoses was found in patent pAVFs using CDU surveillance. These de novo stenoses appear to develop rapidly after arterialization of the upper extremity superficial veins and can be reliably detected by CDU surveillance. Turbulent flow conditions in pAVFs may play a role in inducing progressive vein wall and valve leaflet intimal thickening, although stenoses may be due to venous abnormalities that predate AVF placement. Routine CDU surveillance of pAVFs should be considered to identify and correct flow-limiting stenoses that may compromise pAVF long-term patency and use.

Using B-mode US, symptomatic plaques are more echolucent and less calcified than asymptomatic plaques and are associated with a greater degree of histopathologic plaque necrosis. Such features are indicative of plaque instability and should be considered in the decision-making algorithm when selecting patients with high-grade asymptomatic carotid stenosis for intervention.

No abstract

High-volume surgeons identified more SLNs with IOGP (at the AMC) than without (at the SSCs). They also were more efficient than low-volume surgeons when blue dye alone was used. Low-volume surgeons were almost as efficient as high-volume surgeons when they used IOGP. Optimal identification of SLNs requires nuclear medicine facilities.

Arteriovenous (AV) grafts, which provide an access site for hemodialysis, typically produce a high flow rate environment with pressure and velocity fluctuations; high and low wall shear stress, and vibration. Laser Doppler anemometry (LDA) was performed at Reynolds number (Re) 1200 on an in vitro model, which was constructed from computerized tomography (CT) images of a perfusion fixed plastic cast of a canine venous anastomosis. The results obtained were compared to numerical results and to results previously obtained with idealized in vitro models. This study showed the importance of an accurate geometry in characterizing the flow environment inside an AV graft. Good agreement between the computational fluid dynamics (CFD) and LDA was observed although differences were clearly present.