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Related Experiment Videos

US vascular mapping before hemodialysis access placement.

M L Robbin1, M H Gallichio, M H Deierhoi

  • 1Departments of Radiology, Surgery and Nephrology, University of Alabama Hospital at Birmingham, 619 19th St, South, JTN358, Birmingham, AL 35249-6830, USA. mrobbin@uabmc.edu

Radiology
|September 30, 2000
PubMed
Summary

Preoperative ultrasonography (US) mapping improves surgical selection for hemodialysis access, increasing arteriovenous fistula (AVF) placement and reducing negative exploration rates. This enhanced imaging guides better vascular access procedures.

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Area of Science:

  • Vascular Surgery
  • Nephrology
  • Medical Imaging

Background:

  • Chronic renal failure necessitates vascular access for hemodialysis.
  • Arteriovenous fistulas (AVFs) and grafts are common hemodialysis access types.
  • Optimal selection of vessels is crucial for successful access placement.

Purpose of the Study:

  • To evaluate the impact of preoperative ultrasonography (US) mapping on surgical planning for hemodialysis access.
  • To assess changes in arteriovenous fistula (AVF) and graft placement rates.
  • To determine the effect on negative surgical exploration rates.

Main Methods:

  • Seventy patients with chronic renal failure underwent preoperative US mapping of upper extremity vasculature.
  • Surgeons documented planned procedures based on physical exam before reviewing US findings.

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  • Surgical procedures and outcomes were prospectively recorded.

    • Main Results:

    • US mapping altered the planned procedure in 31% of patients undergoing access placement.
    • Arteriovenous fistula (AVF) placement increased from 32% to 58%.
    • Unsuccessful surgical explorations decreased from 11% to 0%.

    Conclusions:

    • Preoperative US mapping significantly influences surgical management for hemodialysis access.
    • US mapping enhances the likelihood of placing functional arteriovenous fistulas (AVFs).
    • Further research is needed to ascertain long-term outcomes.