Ultrasonographic Assessment of Polytetrafluoroethylene Upper Extremity Arteriovenous Hemodialysis Access: A Retrospective Analysis of 31 Cases

Abstract

Polytetrafluoroethylene (PTFE) vascular grafts are used for hemodialysis vascular access. Because their longevity is less than that of autologous fistulae, close surveillance is necessary to reduce the incidence of complications. The purpose of this study was to evaluate the usefulness of Doppler sonography for the surveillance of PTFE graft hemodialysis access. Thirty-one patients with renal failure who had dialysis access created with a PTFE graft were included in this study. The patient records along with ultrasonography were retrospectively reviewed. Two-dimensional ultrasonography clearly revealed the U-shape of the subcutaneous PTFE graft, and autologous artery and superficial vein connecting with the graft. There was no ultrasound echo inside the graft, but the wall was a continuous line-like hyperechoic structure. Blood flow in the graft and hemodynamic parameters could be determined with color Doppler ultrasonography. Ultrasound examination diagnosed graft thromboses in six patients, pseudoaneurysm in two, seroma in one, and subcutaneous edema in three patients. Ultrasonography is useful for the monitoring and diagnosis of complications of PTFE dialysis access grafts.

The diagnostic value of duplex ultrasound in detecting the presence and location of a stenosis in an autologous arteriovenous fistula

“…Our results are in line with other studies that evaluated the usefulness of Doppler ultrasound in predicting haemodialysis access failure by searching for deviant haemodynamic parameters in patients with a wide variety of complains. 11,[17][18][19] In the study of Bay et al 18 and Ren et al, 17 the population had more polytetrafluoroethylene (PTFE) grafts and less native fistulas than our study cohort. The purpose of our study was to investigate the value of DUS in detecting a stenosis when a change in blood flow was already seen.…”

A case of percutaneous endovascular thrombolysis of a prosthetic graft following occlusion

“…It passed superficially along the medial aspect of the thigh and demonstrated hyperechoic outer lines and an anechoic centre ("double wall appearance") characteristic of a polytetrafluoroethylene graft. 7 With the knee slightly flexed the popliteal artery, tibioperoneal trunk, posterior tibial artery, peroneal artery and anterior tibial artery were also assessed with the 9 to 3Mhz linear array transducer (Figures 1-3). All arteries were F I G U R E 1 Approximate position of transducer at various sites of insonation.…”

“…Scanning in the transverse plane, the prosthetic femoropopliteal bypass graft was identified arising from the medial aspect of the common femoral artery. It passed superficially along the medial aspect of the thigh and demonstrated hyperechoic outer lines and an anechoic centre (“double wall appearance”) characteristic of a polytetrafluoroethylene graft 7 . With the knee slightly flexed the popliteal artery, tibioperoneal trunk, posterior tibial artery, peroneal artery and anterior tibial artery were also assessed with the 9 to 3Mhz linear array transducer (Figures 1‐3).…”