Ultrasonography of the Vascular Access Complications – First Experience

Overview

Background.
Vascular access complications represent leading morbidity of hemodialyzed patients. Duplex Dopplerultrasonography is used rarely in the diagnosis of vascular access complications, despite its simplicity andwidespreadavailability. Our first experience with this method is described, namely the most frequent indications, findings andthe access blood flow correlation.Methods and Results. 356 examinations of both natural and polytetrafluoroethylene (PTFE) accesses at 193 patientswere performed. The 7.5 MHz linear array ultrasound transducer of Hewlett-Packard SONOS 2000 device was used.Both arterial and venous parts of fistulas were examined in all cases. Screening examinations represented the mostfrequent indication, the hemodynamically significant stenosis themost frequent finding. Only 12.5%of PTFE-shuntsand 25.8 % of natural fistulas were described as normal.Mean blood flow through antebrachial and brachial accesseswas 575 and 1070 ml/min, respectively.Conclusions. Prevalence of vascular access complications (especially that of stenoses) is high. Wider use of thismethod could bring significantly improved care for the dialysed patients.

Key words:
vascular access, hemodialysis, ultrasonography, stenosis.