Patient 2

Can you trace the cephalic vein?

This is a 15 year old radio-cephalic fistula in a transplant patient. This fistula is very well developed with a large outflow cephalic vein that is visible even in the arm without a tourniquet.

Move the slider to the left to note the surgical scar in the wrist and the well developed cephalic vein.

Notice the two areas of enlargement on the fistula. This patient has had them for years.  What do you think they are?

This fistula has areas of aneurysmal dilation and you are worried about an underlying venous outflow stenosis.

Review the video and answer the following questions about the physical exam.

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