Journal of vascular surgery
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Comparative Study
Forearm cephalic vein cross-sectional area changes at incremental congestion pressures: towards a standardized and reproducible vein mapping protocol.
Duplex ultrasonography assessment of superficial forearm veins is frequently used before a hemodialysis arteriovenous fistula (AVF) is created. There is, however, no standardized preoperative duplex ultrasonography protocol. This study assessed B-mode image analysis reproducibility and reproducibility of repeated forearm superficial venous diameter measurements on different days at different venous congestion pressures (VCPs). ⋯ Diameter measurements on B-mode images are largely observer independent. Superficial venous cross-sectional area shape is noncircular, and cross-sectional area size depends on VCP. Both maximum and minimum venous diameters should be determined at VCPs >40 mm Hg to attain the best reproducibility. Further studies are needed to determine whether a standardized preoperative vein mapping protocol can reduce AVF nonmaturation rates.
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Comparative Study
Peripheral arterial disease versus other localizations of vascular disease: the ATTEST study.
Despite the increased cardiovascular morbidity and mortality risk of patients with peripheral arterial disease, previous worldwide studies have documented undertreatment of cardiovascular risk factors in such patients. ⋯ Patients with atherothrombotic disease recruited from primary care practices were not adequately tested and treated, especially the patients with peripheral arterial disease. To improve the medical management of patients with peripheral arterial disease, there is a need for epidemiologic and clinical education of physicians.