Becton, Dickinson And Company · NYSE:BDX
Becton, Dickinson And — Technical Presentation
15 slides from Becton, Dickinson And's technical presentation
Slide 1: WavelinQ EndoAVF System Post-Creation Assessment
WAVELINQ™ ENDOAVF SYSTEM POST-CREATION ASSESSMENT BD-14838
Slide 2: AVF Maturation Assessment
AVF Maturation Assessment Physiologic maturation is assessed with ultrasound and physical examination Ultrasound Physical Examination • Assess inflow artery • Visual examination • Assess outflow veins • Palpation of outflow veins
Slide 3: Cannulation Readiness Guidelines
Cannulation Readiness Guidelines WavelinQ™ Clinical Study KDOQI Rule of 6’s1 Robbin’s/UAB Criteria2 Criteria3 • Outflow vein blood flow • Outflow vein blood flow • Arterial inflow blood flow ≥ 600 ml/min ≥ 450 ml/min ≥ 500 ml/min • Outflow vein diameter ≥ 6mm • Outflow vein diameter ≥ 4mm • Outflow
Slide 4: What's different with WavelinQ EndoAVF?
What’s different with WavelinQ™ EndoAVF? Split Vessel Outflow Single Vessel Outflow WavelinQ™ EndoAVF Brachiocephalic AVF Cannulation Zone Note: Purple and yellow veins represent arterialized flow from the AVF EndoAVF Assessment – What to Look For • Arterial inflow blood flow ≥ 500 ml/min1 • Outflow
Slide 5: EndoAVF Maturation Assessment Steps
EndoAVF Maturation Assessment Steps 1. Assess brachial artery inflow 2. Assess cephalic vein outflow, depth & diameter 3. Assess basilic vein outflow, depth & diameter 4. Assess brachial vein flows (if needed) 5. Assess endoAVF creation site – depth & diameter
Slide 6: 1. Check Inflow: Brachial Artery
1. Check Inflow: Brachial Artery Measure inflow blood flow volume in ml/min • Looking for ≥ 500 ml/min1 No tourniquet required Tip: If you don’t see the target flow rate, ask the patient to pump their fist several times and remeasure Sources: 1. WavelinQ Clinical Study Guidelines. BD data on file.
Slide 7: Brachial Artery Flow Analysis
Brachial Artery Flow Analysis Note Diameter Note Diameter Long Axis Long Axis Measure mean flow volume Measure Diameter in color, for 2-3 beats – look for turbulence as a sign of high flow
Slide 8: 2. Check Outflow: Upper Arm Cephalic
2. Check Outflow: Upper Arm Cephalic Use tourniquet Proximal Measure blood flow volume in the proximal / mid / distal area of vein • Target flow volume ≥ 400 ml/min1 • If flow volume < 400 ml/min, then proceed Mid to upper arm basilic vein Measure diameter & depth • Look for ≥ 4 mm diameter2 • Look
Slide 9: Cephalic Vein Assessment
Cephalic Vein Assessment Assess the vein at proximal, mid, and distal segments Short Axis Long Axis Vessel diameter and depth Measure mean flow volume in color, for 2-3 beats
Slide 10: 3. Check Outflow: Upper Arm Basilic
3. Check Outflow: Upper Arm Basilic Use tourniquet Measure flow volume of basilic vein mid / distal • Target flow volume ≥ 400 ml/min1 • If flow volume < 400 ml/min check brachial vein flow volume Check flow volume of median cubital / antecubital vein Measure diameter & depth • Look for ≥ 4 mm diame
Slide 11: Basilic Vein Assessment
Basilic Vein Assessment Long Axis Short Axis Measure mean flow volume Diameter & Depth in color, for 2-3 beats
Slide 12: 4. Brachial Veins – Stealing Flow?
4. Brachial Veins – Stealing Flow? Is outflow vein blood flow volume < 400 ml/min? • If so, check brachial vein flow volume • Check the coiled vein as well (if coiled) What goes in, must come out. If 900 ml/min goes in and you’re only seeing 300 in the cephalic and 200 in the basilic… where is the o
Slide 13: 5. Check EndoAVF Creation Site
5. Check EndoAVF Creation Site If you do not see the target blood inflow or outflow measurements, view the endoAVF creation site
Slide 14: Summary
Summary EndoAVF maturation is assessed by: Brachial artery blood flow ≥ 500 ml/min1 Target cannulation vein diameter ≥ 4 mm1 Cannulation vein (cephalic or basilic) depth ≤ 6 mm2 Sources: 1. WavelinQ Clinical Study Guidelines. BD data on file. 2. NKF KDOQI Clinical Practice Guidelines 2006
Slide 15: WavelinQ EndoAVF System
WavelinQ™ EndoAVF System Indications: The WavelinQ™ EndoAVF System is indicated for the creation of an arteriovenous fistula (AVF) using concomitant ulnar artery and ulnar vein or concomitant radial artery and radial vein in patients with minimum artery and vein diameters of 2.0 mm at the fistula cr
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