Dialysis arteriovenous fistulas: the critical role of color doppler ultrasound

Verbeeck, N; Prospert, Fernand; McIntyre, D.R.; Lamy, S.

doi:10.5334/jbr-btr.663

Cited by 4 publications

(10 citation statements)

References 19 publications

(37 reference statements)

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“…600 mL/min at least) to ensure adequate dialysis without any clinical distal steal. Such uncommon asymptomatic cases are a reason, together with that of more numerous clinically "silent" venous stenoses which flow is also maintained, which motivate, in our Institution, an annual USD assessment of the patients without any biological anomaly during dialysis and without cannulation problems (6). We must notice however that a very careful auscultation of the shunt sometimes enables the detection of its anomaly: if, similarly to the cases of the radiocephalic fistulas without stenosis, the maximum bruit can be heard right above the anastomosis, in the presence of a pre-anastomotic obstacle, an "auscultatory interposition" can be heard, in the sense that a palmar bruit appears whose intensity lies between the one audible at the anastomosis and the one that can be perceived at mid forearm.…”

Section: Discussionmentioning

confidence: 99%

“…frequently diabetic. Juxta pre-anastomotic stenoses or occlusions can also be spotted quite easily (6,7,8). They are generally considered to result from a technical surgical error when they impair the shunt soon after its construction (6).…”

Section: Discussionmentioning

confidence: 99%

“…USD proves particularly successful in detecting extrinsic compressions, partial thromboses or central disorders linked with the cardiac function. On the other hand, it is a bit less efficient than 3D MRA or DSA to assess lesions of the central veins (6).…”

Section: Discussionmentioning

confidence: 99%

“…2/3 of the diameter of the vessel) and of the pulse repetition frequency (PRF). This must be done without any inconsiderate pressure on the transducer, especially in the venous segment of the fistula (6). In case of preanastomotic arterial stenosis we visualize the narrowing directly and we detect a local increase of velocity to more than 3 m/s accompanied by a widening of the Doppler spectrum and an enhancement of the stardust artifact which is normally spotted around the arteriovenous anastomoses (5,6).…”

Section: B Amentioning

confidence: 99%

“…This must be done without any inconsiderate pressure on the transducer, especially in the venous segment of the fistula (6). In case of preanastomotic arterial stenosis we visualize the narrowing directly and we detect a local increase of velocity to more than 3 m/s accompanied by a widening of the Doppler spectrum and an enhancement of the stardust artifact which is normally spotted around the arteriovenous anastomoses (5,6). A pre-anastomotic radial arterial occlusion is clearly visible and the Doppler displays a decreased circulatory velocity at the level of the mid artery whose outflow has collapsed.…”

Section: B Amentioning

confidence: 99%

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A spontaneous pre-anastomotic occlusion does not necessarily impair forearm native dialysis fistulas: echo-Doppler, 3D MR angiographic and digital subtraction angiographic imaging

Verbeeck

Pillet

Prospert

et al. 2013

Journal of the Belgian Society of Radiology

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Renal transplantation is the choice treatment of end-stage renal disease. When it is not indicated or not immediately feasible, hemodialysis must be performed, preferably via a native arteriovenous fistula in the forearm. A pre-anastomotic occlusion of this type of fistula is often accompanied by a thrombosis of its draining vein. In some instances, the venous segment may remain permeable thanks to the development of arterial collateral pathways and may even allow efficient dialysis without any clinical syndrome of distal steal. We present the echo-Doppler, magnetic and angiographic characteristics of three of these collateralized shunts that have remained functional, in one of the cases following a percutaneous dilation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: B Amentioning

confidence: 99%

Section: B Amentioning

confidence: 99%

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A spontaneous pre-anastomotic occlusion does not necessarily impair forearm native dialysis fistulas: echo-Doppler, 3D MR angiographic and digital subtraction angiographic imaging

Verbeeck

Pillet

Prospert

et al. 2013

Journal of the Belgian Society of Radiology

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The Diagnostic Power of Physical Examination on Surgical Planning for Dialysis Access in Sari Imam Hospital Patients from 2013 to 2014

Farsavian¹,

Davoodi²,

Mousavi³

et al. 2016

Vasc Med Surg

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Introduction: It is routine to do physical examination to determine the most suitable place for AV access for haemodialysis. Duplex ultrasonography is a high sensitive modality for the evaluation of vessels and can determine vascular diameter. This study was aimed to evaluate the diagnostic power of physical examination for AV access surgical planning in comparison with Duplex ultrasonography (as the gold standard diagnostic tool). Methods: Physical examination and duplex ultrasonography were done and results were recorded. 117 patients were included on the study. With 95% confidence interval data were analyzed by SPSS 16.0 and sensitivity and specificity of physical examination were calculated. Results: Out of 117 patients, in 60 patients (51.3%), include 33 males and 27 females, physical examination results consistent with Duplex ultrasonography (true positive), with 64.22%, 65% and 86.96% sensitivity, specificity, and positive predictive value, respectively. AVF failure was significantly more observed in snuffbox (forearm) AVF surgery site. Conclusion: Preoperative physical examination can be used initially for patients to evaluate a suitable site for AVF surgery. For better AVF outcome, it's suggested to perform duplex ultrasonography study in patients with insufficient clinical findings, 60 years and older, BMI 25-30, diabetes, and hypertension.

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Paclitaxel-Coated Balloon Angioplasty of Venous Stenoses in Native Dialysis Fistulas: Primary and Secondary Patencies at 6 and 12 Months

Verbeeck

Pillet

Toukouki

et al. 2016

Journal of the Belgian Society of Radiology

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Purpose:When dialysis access stenoses are dilated by noncoated balloons, respective primary and secondary patencies hardly reach 50 per cent and 85 per cent at one year. This study determines the primary and secondary patency rates at 6 and 12 months for venous stenoses treated by paclitaxel-coated balloon (PCB) angioplasty in native hemodialysis accesses.Materials and Methods:From 2012 to 2014, 70 venous stenoses in 41 patients benefited from PCB angioplasties. The patients’ mean age was 62.5 ± 13.8 years’ standard deviation (SD) with 75 per cent male gender, 31.7 per cent diabetes, and 65.9 per cent arterial hypertension. There were 58.5 per cent forearm fistulas and 41.5 per cent arm fistulas. Primary and secondary patency rates were prospectively established by using the Kaplan-Meier technique and tested by using the log-rank test.Results:The primary patency rates ± SD were 81.4 ± 4.6 per cent and 60 ± 5.9 per cent at 6 and 12 months, respectively. The secondary patency rates ± SD reached 94.3 ± 2.8 per cent at 6 months and 91.4 ± 3.3 per cent at 12 months.Conclusion:This study shows an improvement of the primary and secondary patency rates at 6 and 12 months when venous stenoses of native dialysis fistulas are treated by PCB. The indications for PCB, however, remain to be established by larger randomized studies.

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Dialysis arteriovenous fistulas: the critical role of color doppler ultrasound

Cited by 4 publications

References 19 publications

A spontaneous pre-anastomotic occlusion does not necessarily impair forearm native dialysis fistulas: echo-Doppler, 3D MR angiographic and digital subtraction angiographic imaging

A spontaneous pre-anastomotic occlusion does not necessarily impair forearm native dialysis fistulas: echo-Doppler, 3D MR angiographic and digital subtraction angiographic imaging

The Diagnostic Power of Physical Examination on Surgical Planning for Dialysis Access in Sari Imam Hospital Patients from 2013 to 2014

Paclitaxel-Coated Balloon Angioplasty of Venous Stenoses in Native Dialysis Fistulas: Primary and Secondary Patencies at 6 and 12 Months

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