Colour doppler ultrasound assessment of arteriovenous haemodialysis fistulas

Nonnast-Daniel, B.; Lindert, Oliver; Mügge, Andreas; Schaeffer, J.; Koch, K. M.; Daniel, WG; Lieth, H. von der; Söchtig, E; Galanski, Michael; Martin, Ryan C.

doi:10.1016/0140-6736(92)90209-l

Cited by 55 publications

(15 citation statements)

References 7 publications

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“…Many investigators believe that elderly patients do not have suitable vessels for successful creation of an AVF to undergo high-efficiency dialysis, especially when diabetes is present [9,10]. Color duplex ultrasonography has been shown to be useful in the evaluation of vascular access for hemodialysis [11][12][13]. We prospectively studied the fistula blood flow rate and cross-sectional area in patients receiving radiocephalic fistula construction for the first permanent vascular access by means of color duplex ultrasonography and followed the outcome until primary failure or success was assessed.…”

Section: Introductionmentioning

confidence: 99%

Effects of Age and Diabetes on Blood Flow Rate and Primary Outcome of Newly Created Hemodialysis Arteriovenous Fistulas

et al. 1998

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To study the feasibility of creating a radiocephalic hemodialysis fistula in elderly and diabetic patients, we prospectively studied 176 patients undergoing the first permanent vascular access creation and followed the outcome of fistula until primary failure or success was assessed. Color duplex ultrasonography was used to measure the blood flow rate. Fistula blood flow rate was significantly smaller in elderly patients, however, it was >400 ml/min in over 78% of the elderly patients with successful fistulas. There was no difference in fistula blood flow rate between nondiabetics and diabetics. Dialysis adequacy (Kt/V) via fistula was the same between age groups and between diabetes mellitus status. Old age or diabetes per se did not significantly predispose a new fistula to primary failure, but concurrent old age and diabetes markedly increase the risk. In conclusion, a good primary outcome of newly created radiocephalic fistula and adequate dialysis via fistula were demonstrated for elderly and diabetic patients. However, the longevity of fistula in elderly and diabetic patients needs further study.

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Section: Introductionmentioning

confidence: 99%

Effects of Age and Diabetes on Blood Flow Rate and Primary Outcome of Newly Created Hemodialysis Arteriovenous Fistulas

et al. 1998

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“…Color Doppler ultrasound allows the noninvasive inspection of the AV fistula morphology and the quantitative measurement of blood flow with sufficiently high accuracy and sensitivity [7, 10]. Thus, this technique allows the identification of AV fistula dysfunction [7, 10]; however, its value in the diagnosis of the occlusion of a fistula has not been validated by comparison with an objective confirmatory test of occlusion, and, in the few studies in which occlusion was looked for, a sensitivity of 75–94% was observed [10, 15].…”

Section: Discussionmentioning

confidence: 99%

“…Thus, this technique allows the identification of AV fistula dysfunction [7, 10]; however, its value in the diagnosis of the occlusion of a fistula has not been validated by comparison with an objective confirmatory test of occlusion, and, in the few studies in which occlusion was looked for, a sensitivity of 75–94% was observed [10, 15]. …”

Section: Discussionmentioning

confidence: 99%

“…Sophisticated, noninvasive techniques (duplex scan and color Doppler ultrasound) have been used principally to assess the function of vascular accesses, in order to allow an early intervention aimed at preventing occlusion and not to assess patency [5, 6]. Indeed, color Doppler allows both to visualize the AV fistula morphology, comparable to angiography, and to measure the blood flow in the afferent artery [7]. These techniques are expensive and require sophisticated equipment and highly experienced operators.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of Occlusion of the Vascular Access in Patients on Chronic Hemodialysis: Comparison of Physical Examination with Continuous-Wave Doppler Ultrasound

Migliacci¹,

Selli²,

Falcinelli³

et al. 1999

Nephron

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Background: Dialysis access occlusion is the most common cause of hospitalization and a frequent indirect cause of mortality in patients on chronic hemodialysis. The clinical assessment of an arteriovenous shunt is presently the most widely adopted method for the diagnosis of vascular access occlusion in hemodialysis patients, but no studies have yet investigated objectively its sensitivity and positive predictive value (PPV). Continuous-wave (CW) Doppler ultrasound is a simple, inexpensive, and noninvasive technique for the assessment of arterial blood flow. We have carried out a prospective evaluation of the PPV of CW Doppler for the diagnosis of vascular access occlusion in hemodialysis patients and compared it with clinical investigation. Methods: Fourty-one hemodialysis patients with clinical diagnosis of occlusion of their fistula were studied, and in 23 of them the diagnosis of occlusion was objectively validated. Results: CW Doppler in the patients in whom occlusion was objectively validated showed PPV of 86 and 83% under basal conditions and after fistula compression, respectively, with sensitivities of 95 and 100%, respectively. Clinical diagnosis, under the same conditions, showed a PPV of 83% and a sensitivity of 100%. Conclusions: CW Doppler and clinical examination have a similar high sensitivity for the diagnosis of occlusion of the dialysis access; thus, there is no need to use routinely Doppler CW examination, unless objective documentation is required.

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“…Besonders durch die beliebige Wiederholbarkeit der Untersuchungen ist er nicht nur zur Diagnostik, sondern als ShuntmonitoringMethode sehr gut geeignet [5].…”

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Stenosen im Dialyseshunt

Nonnast-Daniel

2006

Nephrologe

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Colour doppler ultrasound assessment of arteriovenous haemodialysis fistulas

Cited by 55 publications

References 7 publications

Effects of Age and Diabetes on Blood Flow Rate and Primary Outcome of Newly Created Hemodialysis Arteriovenous Fistulas

Effects of Age and Diabetes on Blood Flow Rate and Primary Outcome of Newly Created Hemodialysis Arteriovenous Fistulas

Assessment of Occlusion of the Vascular Access in Patients on Chronic Hemodialysis: Comparison of Physical Examination with Continuous-Wave Doppler Ultrasound

Stenosen im Dialyseshunt

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