Hemodialysis access fistula creation: preoperative assessment with MR venography and comparison with conventional venography.

Abstract

MR venography is an accurate, noninvasive technique that is as useful as conventional venography for the planning of hemodialysis access fistula creation.

Upper-Extremity Venography: CO2versus Iodinated Contrast Material

“…I n patients with end-stage renal disease who require hemodialysis, providing vascular access by creating an arteriovenous fistula (AVF) is the preferred approach (1,2). Radiocephalic fistulas are preferred because of a lower complication rate and a greater longevity.…”

“…Radiocephalic fistulas are preferred because of a lower complication rate and a greater longevity. However, when the creation of these passages is not possible, other surgical arteriovenous anastomoses such as primary brachiocephalic or transposed brachiobasilic fistulas in the elbow can be made, or even a polytetrafluoroethylene graft can be inserted (1,2).…”

Pre-Operative Evaluation of Hemodialysis Access Fistula. A Multidisciplinary Approach

“…Although preoperative ultrasound (3) and MR venography (8) have been used with high success rate, conventional venography is still the gold standard and we did not record any related complications. In addition, the accuracy of duplex ultrasound depends on the operator's skills and up to 32% of cases need venography in addition to the duplex (7).…”

Reply

“…Most of these criticisms had already been formulated in a previous issue of "Radiology" by Turmel-Rodrigues et al [1], following the publication of our results [2].…”