| Color doppler ultrasonography imaging to guide transluminal angioplasty of venous stenosis. | |
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MedLine Citation:
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PMID: 11012917 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The objective of access surveillance is the early recognition of dysfunction in order to be able to correct the stenosis by angioplasty or surgery before access thrombosis occurs. The advent of color Doppler imaging has enabled studies of color Doppler ultrasonography (CDU) for the guidance of percutaneous transluminal angioplasty (PTA). The aim of the present study was to investigate whether color Doppler imaging alone can be safely and effectively used to diagnose vascular graft access stenoses and guide subsequent PTA. METHODS: Using the ultrasound velocity dilution method, we measured access blood flow (Qa) during the first hour of hemodialysis every month in patients with grafts as vascular access. When the decrease in Qa from the baseline value was 40% or more, CDU was performed and immediately followed by PTA in the presence of a stenosis of more than 50%. The Qa was then measured during the first dialysis after PTA and one month later. Repeated-measure analysis of variance was applied to evaluate the early and late (after one month) effect of PTA. RESULTS: Twelve PTAs were performed under CDU guidance in nine patients and led to the elimination of the stenosis or its reduction (two cases). The mean Qa was 809 +/- 263 mL/min at baseline, 468 +/- 153 before PTA, and 820 +/- 281 after PTA. The difference between the pre-PTA and post-PTA values was highly significant (P < 0.001), and the mean value after PTA was not different from baseline (P = 0.672). There were no relevant complications directly related to the procedure. CONCLUSIONS: The CDU procedure is effective for the diagnosis of vascular access stenosis and as a guide during the PTA procedure. It could improve stenosis screening by avoiding the risks of exposure to ionizing radiation and of adverse reactions to contrast media. |
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Authors:
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G Bacchini; A Cappello; V La Milia; S Andrulli; F Locatelli |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Kidney international Volume: 58 ISSN: 0085-2538 ISO Abbreviation: Kidney Int. Publication Date: 2000 Oct |
Date Detail:
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Created Date: 2000-10-27 Completed Date: 2000-11-13 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0323470 Medline TA: Kidney Int Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1810-3 Citation Subset: IM |
Affiliation:
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Department of Nephrology and Dialysis, and Department of Radiology, Hospital of Lecco, Lecco, Italy. nefrologia@ospedale.lecco.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Angiography Angioplasty, Balloon / methods* Arteriovenous Shunt, Surgical Constriction, Pathologic Female Graft Occlusion, Vascular / therapy*, ultrasonography* Humans Kidney Failure, Chronic / therapy* Male Middle Aged Regional Blood Flow Renal Dialysis Thrombosis / etiology, therapy, ultrasonography Ultrasonography, Doppler, Color* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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