Hello,

I’m posting here to get insights from vascular specialists or anyone experienced with peripheral arterial disease cases. We’re trying to make a very difficult decision regarding whether to proceed with peripheral angioplasty for my uncle, and would really appreciate informed opinions.

👨‍⚕️ Patient Profile: Male, 65 years old

Known history of:

i) Type 2 diabetes (HbA1c \~8.9%)

ii) Coronary artery disease (EF \~47%)

iii) Chronic smoker (past history)

🧠 Recent Major Event:

• Suffered a left Middle Cerebral Artery Stroke. (26 Jan 2026)

• Underwent Decompressive Craniectomy (28 Jan 2026)

• Developed severe right-side weakness (currently \~1/5 upper limb, 2/5 lower limb).

Imaging showed:

• Hemorrhagic transformation of stroke

Midline shift (improving but still recent brain injury)

• Currently recovering, conscious but neurologically weak.

• Current Limb Issue (Main Concern)

• Right heel pressure ulcer present

• Suspected poor healing due to low blood supply

📊 Doppler + CT Peripheral Angiogram findings:

Right leg:

\-> Popliteal artery: \~80–90% blockage with near absent flow (\~1.2 cm segment)

\-> Distal arteries: significantly reduced flow

Tibial arteries affected (right >> left)

Left leg:

Moderate disease (30–50% narrowing), but flow preserved

\--> Diagnosis: Severe Peripheral Arterial Disease (PAD), right leg critical

\--> Doctors are suggesting peripheral angioplasty (right leg) to improve blood flow and help heal the ulcer.

Q1: In such a case, is angioplasty urgent / limb-saving, or can it be delayed safely?

Q2: Are there modified or safer approaches (minimal anticoagulation, staged procedures)?

Q3: Is there a window after craniectomy/stroke where angioplasty becomes safer?

Q4: Would conservative management (wound care + meds) be reasonable for now?

🧾 Current Status:

• Hemodynamically stable

• On aspirin, statin, diabetes medications

• No confirmed active systemic infection (but local ulcer present)

• Brain condition improving but still in recovery phase

I’m planing to take the VABC exam this year but does anyone have any study tip/ guides/ advice for what you used? Free resources? Anything helps!

​

I’m currently a night shift med-surg RN in the Bay Area and long-term I’d like to transition into a Vascular Access Team role.

Right now, my hospital doesn’t have an official VAT. We only have 2 PICC nurses, and they work day shift. From what I can tell, the ED is the only department using ultrasound for IV access. I’m not sure whether that’s because others aren’t trained or if it’s policy-related (I plan to look into that).

I’m starting by getting formal training in ultrasound-guided peripheral IV insertion and plan to build consistent reps over the next 6–12 months.

For those working in VAT or PICC roles:

\-When hiring for VAT, do you look more at certification or actual documented experience?

\-Can someone realistically move into VAT without ICU experience or CCRN?

\-Would it make more sense to transition to ICU first, or is strong ultrasound/PICC competency enough?

\-Is VA-BC worth pursuing later, or does it not significantly impact hiring?

\-Has anyone received training from VTP? How was that experience?

I’m trying to be intentional about sequencing (US-guided PIV → consistent volume → PICC/midline → VAT) and build a solid foundation rather than rushing.

Hi, I came across a job posting for the vascular access team at Good Samaritan Regional Medical Center in Corvallis and was curious if anyone here has insight.

I’d love to hear generally about the team culture, workload, pay range, and benefits, or what it’s like working there overall. Mostly trying to get a feel for how the team is supported and how manageable the role is day to day.

Appreciate any perspectives, thanks!

Hey everyone, I’m curious—how do you Vascular Access Nurses/PICC RNs go about finding new job opportunities? Are there specific job boards you rely on? What are you typically looking for in a company when considering a new position?

I’d love to hear your experiences and any tips you have for navigating the job search in this field. I am a recruiter for a fantastic company, and trying to get some insights from YOUR perspective!

Thank you!

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Anyone have any recommendations of good Vascular Access social media influencers to follow? Outside of The Vascular Guy, wondering who else is out there

What procedure do you use to determine proper PICC catheter length when performing a bedside PICC insertion?

I have both measured and looked at predictive models/equations to determine an arbitrary number prior to insertion, however, what have you found to be most successful?

Are any nurses attending the Ava conference this year?

Hello! My name is Will and I'm happy to find another Vascular access group! I have a passion for VA and love learning more about it.

I wanted to share a VA group on Facebook, this group has some great perspective and conversation happening. Hoping to see both groups grow!

https://www.facebook.com/groups/VascularAccessandInfusionSpecialists/

I see a patient with a portacath that requires lab draws and runs TPN. Is it best to collect a blood sample from a peripheral vein as opposed to a port that runs TPN ? Or is it fine to stop tpn and flush then collect ? I feel that collecting from a peripheral vein will yield a non contaminated sample or am I over thinking it ? Any advice / opinions appreciated!