Complications of Native Arteriovenous Fistula: The Role of Color Doppler Ultrasonography

Abstract

Color Doppler ultrasonography (CDUS) is a readily available, inexpensive and noninvasive method, which has improved the survival of native arteriovenous fistula (AVF) by increasing the early diagnosis of complications. Although angiography has been currently considered as the gold standard for imaging of vascular access abnormalities, CDUS may be superior in some aspects, since it provides information both on the morphology and on the function of vascular access and it is the only tool directly available to the nephrologist. In addition, CDUS offers the advantage of a non-invasive bedside procedure with lower costs and with no need for radiocontrast.

Ultrasonografia de fistulă arterio-venoasă la pacientul hemodializat cronic – corelații clinico-imagistice

“…Evaluarea stenozelor a ținut cont de recomandările KDIGO și de studiile făcute în ultimii ani (3)(4)(5). Stenoza a fost încadrată ca nesemnificativă (NS) sau semnificativă (SS), în funcție de următorii parametri:…”

“…În lotul studiat, au fost diagnosticate indirect 3 cazuri de stenoză venoasă centrală, prin prezența unui flux de sânge redus și a unui aspect caracteristic de rezistență periferică înaltă al undei spectrale (IR > 0,6, velocitate joasă diastolică), însoțite de circulație colaterală semnificativă și istoric de cateterism venos central ipsilateral. În general, unul dintre neajunsurile ecografiei de FAV este considerat incapacitatea de a vizualiza o stenoză venoasă centrală (5).…”

Standardized Protocol for Hemodialysis Vascular Access Assessment: The Role of Ultrasound and ColorDoppler

“…The echocolorDoppler (ECD) plays an essential role in the study of VA, providing useful information on its anatomy and hemodynamics, which, integrated with dialysis monitor data, become crucial for the proper follow-up of access [5, 6] for the modality of cannulation and for the optimal purification technique according to these elements. Classically, it is known for the utility of the ECD in the study of VA as a non-invasive and repeatable method [7], but it is also attributed to this technique – a significant intra-operator and inter-operator variability that often makes the following-up by different operators difficult [8]. It can determine a not homogeneous and standardized [9] vision overall by the nephrologist and the vascular surgeon.…”

Value of duplex Doppler ultrasonography for the evaluation of dysfunctional hemodialysis access arteriovenous fistulas prior to endovascular interventions

“…4,7,8 Our aim was to demonstrate the accuracy and benefits of DUS for the evaluation of ESRD patients with dysfunctioning AVFs by comparing the lesion detection, localization, and characterization rates with DSA fistulography. However, DSA fistulography has several drawbacks like invasiveness, higher cost, exposure to ionizing radiation, reliance on access to angiography equipment, and administration of iodinated contrast media that might compromise the remaining kidney function.…”

“…DUS was suggested as the first-line choice method in the evaluation of HD access problems. 4,7,8 Our aim was to demonstrate the accuracy and benefits of DUS for the evaluation of ESRD patients with dysfunctioning AVFs by comparing the lesion detection, localization, and characterization rates with DSA fistulography.…”