VASA 2017 Practicum

May 18 - 20, 2017
Washington University
St. Louis, Missouri

The VASA Practicum provides a rare opportunity for healthcare professionals to have “hands-on” experience with surgical and interventional procedures for creating & maintaining vascular access for hemodialysis.

Course Objectives

This course is designed for all transplant, vascular and general surgeons, nephrologists, interventional radiologists, nurses, and dialysis technicians who are interested in the management of vascular access. At the conclusion of this seminar, attendees should be able to:

Observe and perform vascular access procedures in a live animal laboratory.
Receive expert instruction in surgical and interventional hemodialysis access procedures.
Attend didactic presentations, workshops, and one-on-one discussions led by nationally recognized faculty.
Gain experience using ultrasound for evaluation of hemodialysis fistulas and grafts.

Learning and Performance Objectives

The primary purpose of the activity is to provide current information in regards to evaluation, pre-operative, intra-operative, immediate and long-term post-operative management of patients needing vascular access.

At the conclusion of the educational activity the participant should be able to:

Define the problems and risks associated with dialysis access in end stage renal disease patients
Assess and plan for an optimal dialysis access for end stage renal disease patient
Interpret the surgical and medical decision making process of access placement
Discuss various techniques available for peritoneal dialysis catheter placement
Discuss vascular access planning for end stage renal disease patient
Discuss the principles of surgical procedures used to create vascular access
Define the characteristics of a ‘mature vascular access’
Discuss the principles and practice of physical examination to evaluate a vascular access
Describe surgical and radiological procedures used as maturation assist
Recognize long-term problems associated with vascular and discuss the various radiological and surgical methods to correct term
Identify the common vascular and endovascular techniques used in vascular access and use them to optimize patient care
Discuss the role of catheter dialysis, safe catheter placement technique, catheter complications and need for catheter reduction program
Describe new surgical and interventional approaches, new technologies available and new technologies in development

Nursing Activity Objectives

Define the problems and risks associated with dialysis access in end stage renal disease patients
Assess and plan for an optimal dialysis access for end stage renal disease patient
Describe vein preservation strategy and techniques
Discuss the principles of surgical procedures used to create vascular access
Define the characteristics of a ‘mature vascular access’
Discuss the principles and practice of physical examination to evaluate a vascular access
Describe the hemodialysis machine and significance of various alarms
Discuss various dialysis access cannulation techniques
Describe the buttonhole technique
Discuss the role of catheter dialysis, safe catheter placement technique, catheter complications and need for catheter reduction program
Discuss catheter care techniques
Able to communicate the access associated problem with the access care provider (interventionalist or surgeon)

PHOTO GALLERY

THURSDAY, MAY 18, 2017
07:00 PM - 09:00 PM	Registration \| Welcome Reception

FRIDAY, MAY 19, 2017
06:30 AM - 07:00 AM	Registration \| Continental Breakfast
07:00 AM - 07:30 AM	Welcome & Introductions
PHYSICIAN ACTIVITY CONCURRENTS
08:00 AM - 10:00 AM SESSION I	Procedural experience This activity allows live viewing of surgical and interventional procedures related to vascular access and interact with operating surgeons and interventionalist performing them. Vivarium experience Attendees (surgeons and Interventionalist) spend time in the Vivarium with faculty honing and perfecting vascular access related surgical and interventional techniques. Explore the human cadaver limb and work in animal lab with hands on and image guided techniques related to AVF and AVG placement and interventions. Ultrasound and simulation experience Attendees (physicians and surgeons) will learn the technioques of using the Ultra Sound in the field of vascular access. This includes, but not limited to, vessel mapping, AVG and AVF maturation evaluation, access monitoring and evaluation of access complications in patient volunteers.
ALLIED HEALTH ACTIVITY CONCURRENTS
08:00 AM - 10:00 AM SESSION I	Procedural experience This activity allows live viewing of surgical and interventional procedures related to vascular access and interact with operating surgeons and interventionalist performing them. Access anatomy, US monitoring and Cannulation experience Hands on experience with AVF fistula cannulation with state of the art simulators. Learn different cannulation techniques including the button hole cannulation. Realtime ultrasonography and sonographic guidance for cannulation real time patient evaluation to save the vein and access monitoring. Dialysis clinic experience Learn to trouble shoot problems experienced in the dialysis setup and delivery. A simple one minute access check to complex issues with dialysis machines. pump speeds, pressures, access flow, cardiac output monitors, recirculation and access surveillance. Includes trouble shooting with hemodialysis machines and catheters and peritoneal dialysis.
10:00 AM - 10:30 AM	Break \| Exhibits
PHYSICIAN ACTIVITY CONCURRENTS
10:30 AM - 12:30 PM SESSION II	Procedural experience This activity allows live viewing of surgical and interventional procedures related to vascular access and interact with operating surgeons and interventionalist performing them. Vivarium experience Attendees (surgeons and Interventionalist) spend time in the Vivarium with faculty honing and perfecting vascular access related surgical and interventional techniques. Explore the human cadaver limb and work in animal lab with hands on and image guided techniques related to AVF and AVG placement and interventions. Ultrasound and simulation experience Attendees (physicians and surgeons) will learn the technioques of using the Ultra Sound in the field of vascular access. This includes, but not limited to, vessel mapping, AVG and AVF maturation evaluation, access monitoring and evaluation of access complications in patient volunteers.
ALLIED HEALTH ACTIVITY CONCURRENTS
10:30 AM - 12:30 PM SESSION II	Procedural experience This activity allows live viewing of surgical and interventional procedures related to vascular access and interact with operating surgeons and interventionalist performing them. Access anatomy, US monitoring and Cannulation experience Hands on experience with AVF fistula cannulation with state of the art simulators. Learn different cannulation techniques including the button hole cannulation. Realtime ultrasonography and sonographic guidance for cannulation real time patient evaluation to save the vein and access monitoring. Dialysis clinic experience Learn to trouble shoot problems experienced in the dialysis setup and delivery. A simple one minute access check to complex issues with dialysis machines. pump speeds, pressures, access flow, cardiac output monitors, recirculation and access surveillance. Includes trouble shooting with hemodialysis machines and catheters and peritoneal dialysis.
12:30 PM - 01:00 PM	Boxed Lunch
PHYSICIAN ACTIVITY CONCURRENTS
01:00 PM - 03:00 PM SESSION III	Procedural experience This activity allows live viewing of surgical and interventional procedures related to vascular access and interact with operating surgeons and interventionalist performing them. Vivarium experience Attendees (surgeons and Interventionalist) spend time in the Vivarium with faculty honing and perfecting vascular access related surgical and interventional techniques. Explore the human cadaver limb and work in animal lab with hands on and image guided techniques related to AVF and AVG placement and interventions. Ultrasound and simulation experience Attendees (physicians and surgeons) will learn the technioques of using the Ultra Sound in the field of vascular access. This includes, but not limited to, vessel mapping, AVG and AVF maturation evaluation, access monitoring and evaluation of access complications in patient volunteers.
ALLIED HEALTH ACTIVITY CONCURRENTS
01:00 PM - 03:00 PM SESSION III	Procedural experience This activity allows live viewing of surgical and interventional procedures related to vascular access and interact with operating surgeons and interventionalist performing them. Access anatomy, US monitoring and Cannulation experience Hands on experience with AVF fistula cannulation with state of the art simulators. Learn different cannulation techniques including the button hole cannulation. Realtime ultrasonography and sonographic guidance for cannulation real time patient evaluation to save the vein and access monitoring. Dialysis clinic experience Learn to trouble shoot problems experienced in the dialysis setup and delivery. A simple one minute access check to complex issues with dialysis machines. pump speeds, pressures, access flow, cardiac output monitors, recirculation and access surveillance. Includes trouble shooting with hemodialysis machines and catheters and peritoneal dialysis.
03:00 PM - 03:30 PM	Refreshment Break & Exhibitis
03:30 PM - 04:30 PM	Vascular Access Clinic This session will broadcast an access clinic with clinical evaluations of new and established patients, with panel discussion.

SATURDAY, MAY 20, 2017
07:00 AM - 08:00 AM	Continental Breakfast
07:30 AM - 08:00 AM	Continental Breakfast
08:30 AM - 10:00 AM	General Sessions I Tailoring dialysis treatments to patient needs Speaker: Brent Miller, MD Functional vascular access Speaker: Monnie Wasse, MD Vascular access evaluation Speaker: John Lucas, MD Central venography Speaker: John Aruny, MD AVF creation – SLOT technique Speaker: Jaime Velez, MD AV graft placement Speaker: David Leeser, MD AVG - the ‘super Hero’ Speaker: Stephen Hohmann, MD, FACS PD catheter placement Speaker: Ingemar Davidson, MD Moderators: Jack Work, MD; Yael Vin, MD, MPH
10:00 AM - 10:30 AM	Break
10:30 AM - 12:00 PM	General Sessions II Management of deep outflow veins Speaker: Jason Wellen, MD Surgical techniques for AV access salvage Speaker: Eric Peden, MD Aneurysm repair Speaker: Surendra Shenoy, MD, PhD Managing steal a flow based algorithm Speaker: William Jennings, MD Flow reduction with banding Speaker: Yael Vin, MD, MPH Cannulation techniques Speaker: Cheryl Cress, RN TDC: how do they differ Speaker: Dirk Hentschel, MD Thoracic outlet obstruction 1st rib resection Speaker: Robert Thompson, MD, FACS Moderators: Karl Illig, MD, FACS; Aris Urbanes, MD
12:00 PM - 01:00 PM	Boxed Lunch
01:00 PM - 02:00 PM	General Sessions III Percutaneous AV access creation and results of NEAT trial Speaker: Charmaine Lok, MD Sirolimus wrap for AVF technique and early clinical outcome Speaker: Sriram Iyer, MD Human bioengineered AV grafts – what do we know Speaker: Jeff Lawson, MD, PhD Balloon angioplasty Speaker: Jeffrey Hoggard, MD, FACP, FASN, FASDIN Stent graft placement – Indications and technique Speaker: Dirk Hentschel, MD Hybrid graft placement – How I do it Speaker: David Leeser, MD Moderator: Larry Scher, MD
PHYSICIAN ACTIVITY
02:00 PM - 02:30 PM	General Sessions IV ESRD Seamless Care Organization (ESCO) what it means for vascular access Speaker: Aris Urbanes, MD Review of major changes in HDA coding for 2017 Speaker: Gerald Beathard, MD, PhD Health economics and early cannulation grafts Speaker: Marc Glickman, MD
ALLIED HEALTH ACTIVITY
02:00 PM - 02:30 PM	General Sessions IV Acute Kidney Care and the vascular access challenges Speaker: Janet Holland, RN, CNN AVF Maturing and AVG healing - FF tools Speaker: Deborah Brouwer Meir, RN, CNN Now that you have access flow measurements from the surveillance, how do you identify the patients at risk of high cardiac output failure and how to manage? Speaker: Monnie Wasse, MD
02:30 PM - 03:00 PM	Break
PHYSICIAN ACTIVITY
03:00 PM - 04:30 PM	General Sessions V Case presentations and discussion
ALLIED HEALTH ACTIVITY
03:00 PM - 04:30 PM	General Sessions V ESRD Network – QIP for vascular access Speaker: Sharlyn Bogner, MSN, RN, CNN, CCTC, CPHQ ESRD Seamless Care Organization (ESCO) what it means for vascular access Speaker: Aris Urbanes, MD Your role as a VAC- what do you need to support or advance your role - Open Discussion Speakers: Deborah Brouwer Meir, RN, CNN; Janet Holland, RN, CNN; Cheryl Cress, RN Patient Case Review and Access Questions – Panel Discussion Speakers: Janet Holland, RN, CNN; Forest Rawls; Lisa Koester Wiedemann, NP, ANP, CNN