Year 2021, Volume 7 , Issue 1, Pages 74 - 79 2021-01-04

How to perform surgical planning for hemodialysis access? Routine preoperative doppler ultrasound mapping

Nurullah DOĞAN [1] , Omer Fatih NAS [2]


Objectives: The aim of the study was to evaluate the effect of routine preoperative Doppler ultrasound mapping on surgical planning in patients having hemodialysis fistulas.

Methods: Patients with arteriovenous fistulas (AVF) or arteriovenous grafts (AVG) were retrospectively reviewed between June 2010 and July 2017. Physical findings, preoperative Doppler ultrasound and postoperative findings of 1924 patients were reviewed.

Results: Fistula maturation rate was 82%. The average duration of patency of the first fistula was 19 months (3-38 months) and the duration for a previous fistula operation history was 11 months (1-14 months). Patency rate after 6 months was 78%. Mean maturation times for AVF and AVG were 70 and 28 days, respectively. Doppler ultrasound findings affected operation plans of surgeons in 227 of 908 (25%) first time fistula operation patients, and in 569 of 1016 (56%) patients with previous history of fistula surgery. Review of two groups revealed that Doppler ultrasound affected 41% (796/1924) of fistula planning of surgery for hemodialysis.

Conclusions: We suggest that preoperative Doppler ultrasound should be routinely performed in patients undergoing fistulation for hemodialysis. Furthermore, a vascular radiologist and a vascular surgeon should decide the surgical plan together.

arteriovenous fistulas, arteriovenous grafts, Doppler ultrasound, hemodialysis
  • 1. Bylsma, LC, Gage SM, Reichert H, Dahl SLM, Lawson LH. Arteriovenous fistulae for hemodialysis: a systematic review and meta-analysis of efficacy and safety outcomes. Eur J Vasc Endovasc Surg 2017;54:513-22.
  • 2. Georgiadis GS, Charalampidis DG, Argyriou C, Georgakarakos EI, Lazarides MK. The necessity for routine pre-operative ultrasound mapping before arteriovenous fistula creation: a meta-analysis. Eur J Vasc Endovasc Surg 2015;49:600-5.
  • 3. Zamboli P, Fiorini F, D'Amelio A, Fatuzzu P, Granata A. Color Doppler ultrasound and arteriovenous fistulas for hemodialysis. J Ultrasound 2014;17:253-63.
  • 4. Wong CS, McNicholas N, Healy D, Clarke-Moloney M, Coffey JC, Grace PA, et al. A systematic review of preoperative duplex ultrasonography and arteriovenous fistula formation. J Vasc Surg 2013;57:1129-33.
  • 5. National Kidney Foundation Kidney Disease Outcomes Quality Initiative: 2006 update vascular access. Guideline 2: selection and placement of hemodialysis access. Am J Kidney Dis 2006;48:192-200.
  • 6. Tordoir J, Canaud B, Haage P, Konner K, Basci A, Fouque D, et al. EBPG on vascular access. Nephrol Dial Transplant 2007;22:88-117.
  • 7. Patel ST, Hughes J, Mills JL. Failure of arteriovenous fistula maturation: an unintended consequence of exceeding Dialysis Outcome Quality Initiative guidelines for hemodialysis access. J Vasc Surg 2003;38:439-45.
  • 8. Mat Said N, Musa KI, Mohamed Daud MA, Haron J. The combination of sonography and physical examination improves the patency and suitability of hemodialysis arteriovenous fistula in vascular access. Malays J Med Sci 2016;23:26-32.
  • 9. Silva MB Jr, Hobson RW II, Pappas PJ, Araki CT, Goldberg MC, Gwertzman, et al. A strategy for increasing the use of autogenous hemodialysis access procedures: impact of perioperative noninvasive evaluation. J Vasc Surg 1998;27:302-7.
  • 10. Ferring M, Claridge M, Smith SA, Wilmink T. Routine preoperative vascular ultrasound improves patency and use of arteriovenous fistulas for hemodialysis: a randomized trial. Clin J Am Soc Nephrol 2010;5:2236-44.
  • 11. Smith GE, Samuel N, Khan J, Johnson BF, Chetter IC. Targeted duplex ultrasound in a one-stop dialysis vascular access assessment clinic. Ann Vasc Surg 2011;25:1099-103.
Primary Language en
Subjects Radiology, Nuclear Medicine, Medical Imaging
Journal Section Original Articles
Authors

Orcid: 0000-0003-1455-6918
Author: Nurullah DOĞAN (Primary Author)
Institution: Department of Radiology, Doruk Medical Center, Bursa, Turkey
Country: Turkey


Orcid: 0000-0001-6211-4191
Author: Omer Fatih NAS
Institution: Department of Radiology, Uludağ University School of Medicine, Bursa, Turkey
Country: Turkey


Dates

Application Date : October 28, 2019
Acceptance Date : March 12, 2020
Publication Date : January 4, 2021

EndNote %0 The European Research Journal How to perform surgical planning for hemodialysis access? Routine preoperative doppler ultrasound mapping %A Nurullah Doğan , Omer Fatih Nas %T How to perform surgical planning for hemodialysis access? Routine preoperative doppler ultrasound mapping %D 2021 %J The European Research Journal %P -2149-3189 %V 7 %N 1 %R doi: 10.18621/eurj.638967 %U 10.18621/eurj.638967