Hemodialysis Access: US for Preprocedural Mapping and Evaluation of                     Maturity and Access Dysfunction

Sharbidre, Kedar G.; Alexander, Lauren F.; Varma, Rakesh K.; Al-Balas, Alian A.; Sella, David M.; Caserta, Melanie P.; Clingan, M. Jennings; Zahid, Mohd; Aziz, Muhammad U.; Robbin, Michelle L.

doi:10.1148/rg.230053

Cited by 3 publications

(2 citation statements)

References 66 publications

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“…Haemodialysis provides various options for vascular access, including native arteriovenous fistulas (AVFs), arteriovenous grafts (AVGs), and central intravenous catheters. However, the use of catheters should be avoided due to their association with greater risks of mortality, infection, cardiovascular events, and hospitalisation compared to AVFs or AVGs [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…Arteriovenous fistulas have garnered strong endorsement as the favoured vascular access choice for extended haemodialysis, with support from reputable organisations such as the National Kidney Foundation (NKF), the European Best Practice Guidelines Expert Group (EBPG) on Haemodialysis, and the Society for Vascular Surgery (SVS) [3][4][5]. Functioning AVFs exhibit a lower incidence of mortality, infection, and hospitalisation compared to AVGs [1,6]. Furthermore, AVFs require fewer interventions to keep their patency over the long term [7].…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic performance and inter-reviewer agreement of colour Doppler ultrasound in haemodialysis fistula and graft complications: a multicentre prospective study

Mohamed,

Nada,

Libda

et al. 2024

Pol J Radiol

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PurposeHaemodialysis provides various options for vascular access, including native arteriovenous fistulas (AVFs), arteriovenous grafts (AVGs), and central intravenous catheters. However, the use of catheters should be avoided due to their association with greater risks when opposed to AVFs or AVGs. AVFs have garnered strong endorsement as the favoured vascular access choice for extended haemodialysis.Material and methodsA total of 200 patients initially diagnosed with AVF/AVG dysfunction were referred to the radiology department across 3 different institutions. The inclusion criteria involved patients who encountered repeated difficulties with access cannulation during dialysis. Conversely, the exclusion criteria comprised cases that had been solely assessed using colour Doppler ultrasound (CDUS), those exclusively evaluated with digital subtraction angiography (DSA), situations where DSA was not feasible, instances requiring immediate intervention due to acute access failure, and cases in which patients refused participation.ResultsInter-observer agreement regarding complications of AVF/AVG was very good for the identification of thrombus (κ = 1.0), seroma (κ = 0.953), aneurysm (κ = 0.851), and pseudoaneurysm (κ = 0.851). It was considered good for the detection of juxta-anastomosis stenosis (κ = 0.751) and feeding artery stenosis (κ = 0.638). However, the agreement was fair for identifying draining vein stenosis (κ = 0.380) and distal arterial steal syndrome (κ = 0.210). The overall diagnostic performance of CDUS exhibited 86% sensitivity in identifying stenosis, with a specificity of 99.1%, a positive predictive value (PPV) of 96.5%, a negative predictive value (NPV) of 97%, and an accuracy of 94.3%.ConclusionsCDUS is a noninvasive diagnostic approach for the prompt picking of AVF complications. It serves as a suitable first-line imaging modality for nonfunctional AVF due to its cost-effectiveness and accessibility. Additionally, we provide evidence of reproducibility, encouraging the diligent use of CDUS in AVF and AVG evaluation for early complication detection and management guidance.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diagnostic performance and inter-reviewer agreement of colour Doppler ultrasound in haemodialysis fistula and graft complications: a multicentre prospective study

Mohamed,

Nada,

Libda

et al. 2024

Pol J Radiol

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Flow versus Form: A New Approach to Assessing Dialysis Fistulas

Prince,

Sos,

Weintraub

2024

Radiology

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Ultrasound evaluation of arteriovenous fistula for hemodialysis

Polukhina

2024

jour

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The article presents a pictorial literature review on ultrasound evaluation of arteriovenous fistula for hemodialysis in patients with end-stage renal failure. Native arteriovenous fistula (AVF) is considered the “gold standard” of vascular access. Nowadays ultrasound is the first-line imaging modality of management of patients receiving hemodialysis treatment at all stages. The article highlights the role of ultrasound in preoperative assessment when planning the AVF creation, assessing the maturation of vascular access, as well as early detection of its dysfunction. The main complications of arteriovenous fistulas are presented, and examples of their diagnosis using the ultrasound are given.

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Hemodialysis Access: US for Preprocedural Mapping and Evaluation of Maturity and Access Dysfunction

Cited by 3 publications

References 66 publications

Diagnostic performance and inter-reviewer agreement of colour Doppler ultrasound in haemodialysis fistula and graft complications: a multicentre prospective study

Diagnostic performance and inter-reviewer agreement of colour Doppler ultrasound in haemodialysis fistula and graft complications: a multicentre prospective study

Flow versus Form: A New Approach to Assessing Dialysis Fistulas

Ultrasound evaluation of arteriovenous fistula for hemodialysis

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