Creating
AV Fistulas in All Eligible Hemodialysis Patients
Release
Date April 2005, valid thru April 2007. Copyright 2005 by Lawrence
Spergel, MD, FACS and William Jennings, MD, FACS. All rights reserved.
No part of this program may be reproduced in any manner whatsoever without
written permission from the publisher, except as indicated in the instructions
herein.
OUHSC,
College of Medicine, Office of Continuing Medical Education, 800 N.E.
15th Street, Oklahoma City, OK 73104,
(888) 682-6348. This activity is presented by the University of Oklahoma
College of Medicine, Office of Continuing Medical Education in conjunction
with the University of Oklahoma College of Medicine, Tulsa, Department
of Surgery.
COURSE
NUMBER: 5E016WEB
PROGRAM
INTRODUCTION
PURPOSE
Vascular
Access is required for patients receiving hemodialysis therapy for renal
failure. The purpose of this presentation is to educate any physician
who provides or directs vascular access placement for hemodialysis patients.
To
immediately view the presentations, scroll down to implementation.
To
print handouts to accompany the presentations, scroll down to miscellaneous
training materials.
EDUCATIONAL
OUTLINE
•
Introduction
•
Fistula First Initiative
•
Preoperative
Evaluation and Introduction to Ultrasound
•
Cimino
and Brachial AV Fistulas, Technical Considerations
•
Proximal
Radial Artery AV Fistulas
•
Endovascular
Presentation of Immature and Dysfunctional AVF's
•
AV
Fistula Vein Transpositions
•
Difficult
AV Fistula Extremities
•
Endovascular
Recanalization of Thrombosed AVF's
•
Secondary
AV Fistulas, Converting Grafts
•
Management
of Steal Syndrome
•
Panel
Discussion
•
Ultrasound:
Overview of AVF Venous Mapping
•
Cimino
/ Distal Radial Artery AVF, Preoperative Ultrasound Exam
•
Proximal
Radial Artery AVF
•
Proximal
Radial Artery AVF with Angioscopy
•
Staged
Transposition AVF
•
Proximal
Radial Artery AVF, Preoperative Ultrasound Exam
EDUCATIONAL
OBJECTIVES
Upon
completion of this activity, the participant should be able to:
•
Utilize ultrasound for preoperative and
postoperative venous mapping and decision-making.
•
Predict which fistula location will be most
likely to succeed.
•
Construct successful Cimino, proximal radial
artery, and transposition AV fistulas.
•
Identify the difficult access extremity
and utilize techniques to accomplish AV fistula construction in these
cases.
•
Convert established grafts to AV fistulas.
•
Define the role for the interventionalist
in dialysis access.
•
Review AV fistula construction techniques.
EXPECTED
OUTCOMES
The
participating physicians will practice better patient care through the
understanding of how to identify and treat patients with the need for
vascular access for hemodialysis.
This
activity did not receive any commercial support for the development of
this presentation.
TARGET
AUDIENCE
The
target audience includes a) vascular access surgeons, b) interventional
radiologists/nephrologists, and c) nephrologists.
IMPLEMENTATION
The
estimated time for completion of this program is 10.5 hours. Miscellaneous
training materials below contains the slides, handout and video clips.
To optimize your educational experience, we encourage you to print the
handout material to reference while viewing the presentations.
•
Start the presentations by clicking the
links below:
(requires Windows
Media Player 9.0 or higher, Internet
Explorer 5.0 or
later,
Netscape Navigator 7.0 or later, or Internet Explorer 5.2.2 or later for
the Mac).
•
Introduction
•
Fistula
First Initiative
•
Preoperative
Evaluation and Introduction to Ultrasound
•
Cimino
and Brachial AV Fistulas, Technical Considerations
•
Proximal
Radial Artery AV Fistulas
•
Endovascular Presentation of Immature and
Dysfunctional AVF's
•
AV
Fistula Vein Transpositions
•
Difficult
AV Fistula Extremities
•
Endovascular
Recanalization of Thrombosed AVF's
•
Secondary AV Fistulas, Converting Grafts
•
Management
of Steal Syndrome
•
Panel
Discussion
•
Ultrasound:
Overview of AVF Venous Mapping
•
Cimino
/ Distal Radial Artery AVF, Preoperative Ultrasound Exam
•
Proximal
Radial Artery AVF
•
Proximal
Radial Artery AVF with Angioscopy
•
Staged
Transposition AVF
•
Proximal Radial Artery AVF, Preoperative
Ultrasound Exam
•
Print
a copy of the test and evaluation
( PDF
format / Word
format ).
•
Discuss the information covered with your
staff or colleagues.
•
Return to your test answer sheet for a final
review.
•
Complete and return the CME test answer
sheet and course evaluation.
PROGRAM
FACULTY
Lawrence
Spergel, M.D., FACS
Clinical
Chair, NVAII (Fistula First),
Director,
Dialysis Management Medical Group, San Francisco, CA
William
Jennings, M.D., FACS
Associate
Professor, Department of Surgery
Mary Louise Todd Cardiovascular Chair
The
University of Oklahoma
College
of Medicine, Tulsa, OK
W.
Perry Arnold, M.D.
Dialysis
Access Specialists, RMS Lifeline, Inc.
Baltimore/Timonium,
MD
Miscellaneous
Training Materials
The PowerPoints, handouts and video clips were made available in an effort
to spread the educational materials throughout the local/regional communities.
Please feel free to utilize PowerPoints to perform local presentations
of materials.
AV
Fistula PowerPoint handouts:
Endovascular Preservation of Immature and Dysfunctional AVFs,
W. Perry Arnold, MD
Wrist (Cimino)
and Brachial AVF's, William Jennings, MD, FACS
AV
Fistulas in Most (All?) Patients: Exploiting the Proximal Artery
(black and white copy), William Jennings, MD, FACS
AV
Fistulas in Most (All?) Patients: Exploiting the Proximal Artery
(color copy), William Jennings, MD, FACS
AV
Fistulas: The Difficult Access Patient, William Jennings,
MD, FACS
FistulaFirst:
The National Vascular
Access Improvement Initiative
(NVAII), Lawrence M. Spergel, MD, FACS
FistulaFirst:
The National Vascular Access
Improvement Initiative (NVAII),
Surgical
Approaches to A-V Fistula Construction:
Secondary AVFs, Lawrence M. Spergel, MD, FACS
FistulaFirst: The National Vascular
Access Improvement Initiative
(NVAII),
Management
of Steal Syndrome, Lawrence M. Spergel, MD, FACS
Endovascular
Recanalization of Thrombosed AVF's, W. Perry Arnold, MD
FistulaFirst:
The National Vascular Access
Improvement Initiative (NVAII),
Surgical
Approaches to A-V Fistula
Construction: Vein Transpositions, Lawrence M. Spergel, MD,
FACS
PROGRAM
PLANNING COMMITTEE
Nancy
Armistead, MPA, Chair, NW 5; Ann Pridgen, RN,
NW 8; Linda Duval, RN, BSN, NW 13; Sarah Yelton,
RN, CNN, NW 12; Glenda Harbert, RN, CNN, CPHQ,
NW 14; Jefferson Rowland, Science Officer, CMS RO, Boston;
Emily Hodgin, RN, BSN, CNN, CPHQ, NW 6; Lawrence Spergel,
M.D., FACS, Clinical Chair, NVAII; Mark
Meier, MSW, NW 11; Vickie Peters, MSN, MAED, RN,
CPHQ, NCC Support.
Disclaimer:
This material was prepared by NCC under contract #500-02-NW18CH with the
Centers for Medicare & Medicaid Services (CMS). The contents
do not necessarily reflect CMS policy.
DISCLOSURE
POLICY
It
is the policy of The University of Oklahoma Health Sciences Center College
of Medicine to ensure balance, independence, objectivity and scientific
rigor in all its educational programs. All faculty participating in these
programs are expected to disclose to the program audiences any real or
apparent conflict of interest related to the content of their presentation.
SPEAKER
DISCLOSURE
The
University of Oklahoma College of Medicine Irwin Brown Office of Continuing
Medical Education has adopted a policy regarding disclosure affecting
continuing medical educational programs. Program faculty are asked to
disclose any affiliations or financial interests they may have in any
organization that may have an interest in their comments. The following
information was received from the faculty:
W.
Perry Arnold, M.D. - Consultant for MedComp, Angiodynamics
Lawrence
Spergel, M.D., FACS - Consultant for Institute for Health Care Improvement
William
Jennings, M.D., FACS - Nothing to disclose
ACKNOWLEDGMENTS
The
majority of this presentation was videotaped at the "Creating AV Fistulas
in Most (All?) Hemodialysis Patients" surgical course held in Tulsa, OK
on Friday, September 10, 2004.
ACCREDITATION
AND CREDITS
The
University of Oklahoma College of Medicine is accredited by the ACCME
to provide continuing medical education for physicians. The University
of Oklahoma College of Medicine designates this activity for a maximum
of 10.5 category 1 credit towards the AMA Physician's Recognition Award.
Each physician should claim only those credits that she/he actually spent
in the educational activity.
American
Academy of Physician Assistants (AAPA) accepts AMA/PRA Category 1 credit
from organizations accredited by ACCME.
HOW
TO OBTAIN CONTINUING MEDICAL EDUCATION CREDITS
A
certificate of completion will be awarded to physicians completing the
program (with a score of 70% or higher). In order to receive your continuing
medical education credits, the accompanying answer sheet and course evaluation
must be filled out completely and mailed along with a check (payable to
OUHSC/CME) for $25.00 to:
The Irwin Brown Office of Continuing Medical Education
P.O. Box 26901 - ROB 202
Oklahoma City, OK 73190
(Tax ID 73-601-7987)
If
you prefer to pay by credit card, you can fax the answer sheet and course
evaluation. The credit card information is included on the answer sheet.
You may fax your test and course evaluation form to us at (405) 271-3087.
You
may view the test, answer sheet, and course evaluation in
PDF and
Word format . Viewing the documents in PDF format requires you to
have the free Adobe
Reader installed on your computer. Viewing the documents in
Word format requires you to have Microsoft Word or the Word
Viewer installed on your computer. If you have questions,
please call us at (888) 682-6348, ext. 6.
You
will receive a certificate of completion within 7-10 days after receipt
of your test and evaluation. In the event you fail, you will be notified
regarding a retake examination on the same concepts.
|
