Document Detail

The Key Role of Color Doppler Ultrasound in the Work-up of Hemodialysis Vascular Access.
MedLine Citation:
PMID:  25264303     Owner:  NLM     Status:  Publisher    
Vascular access (VA) is the lifeline for the hemodialysis patient and the native arterio-venous fistula (AVF) is the first-choice access. Among the different tests used in the VA domain, color Doppler ultrasound (CD-US) plays a key role in the clinical work-up. At the present time, three are the main fields of CD-US application: (i) evaluation of forearm arteries and veins in surgical planning; (ii) testing of AVF maturation; (iii) VA complications. Specifically, during the AVF maturation, CD-US allows to measure the diameter and flow volume in the brachial artery and calculate the peak systolic velocity (PSV) of the arterial axis, anastomosis and efferent vein, to detect critical stenosis. The borderline stenosis, revealed by the discrepancies between access flow rate and PSV, should be followed up with subsequent tests to detect progression of stenosis; the cases with significant changes in brachial flow should be referred to angiography. In conclusion, clinical monitoring remains the backbone of any VA program. CD-US is of utmost importance in a patient-centered VA evaluation, because it allows the appropriate management of all aspects of VA care. These are the main reasons why we strongly advocate the adoption of a VA surveillance program based on CD-US.
Carlo Lomonte; Mario Meola; Ilaria Petrucci; Francesco Casucci; Carlo Basile
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-9-29
Journal Detail:
Title:  Seminars in dialysis     Volume:  -     ISSN:  1525-139X     ISO Abbreviation:  Semin Dial     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-9-29     Completed Date:  -     Revised Date:  2014-9-30    
Medline Journal Info:
Nlm Unique ID:  8911629     Medline TA:  Semin Dial     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2014 Wiley Periodicals, Inc.
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