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| Monitoring vascular complications on autogenous arteriovenous fistulas in hemodialysis patients: value of high-frequency ultrasound |
| DING Hong1, GU Qi-lan1, ZHU Yu-li2, ZHOU Zhi-ying1, BAI Shou-jun1 |
| 1. Qingpu Branch, Zhongshan Hospital, Fudan University, Shanghai 201700, China; 2. Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China |
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Abstract Objective: To assess the value of high-frequency ultrasound in monitoring vascular complications on autogenous arteriovenous fistulas(AVF) in hemodialysis patients. Methods: Eighty-one patients with clinically normal hemodialysis access were examined with color Doppler ultrasound. The structure of AVF, peak systolic velocity, resistance index(RI) and blood flow volume of branchial artery were recorded. Results: Among 81 AVF patients, 45(55.6%) were normal in structure, and 36(44.4%) were abnormal including 14 venous dilatation, 12 thrombosis, 9 arterial steal symptom and 1 pseudoaneurysm. There were 8(9.9%) cases diagnosed as AVF stenosis due to thrombosis. The mean flow volume of all patients was (1 146±410) mL/min(203~2 390 mL/min). The incidence of vascular complications was higher in low(<800 mL/min) and high(≥1 500 mL/min) blood flow volume groups than in the middle volume group(P<0.05). The blood flow volume in stenosis cases was (375±124) mL/min, which was significantly lower than no complication group(P<0.05). There was also statistically significant difference in the diameter of stenostic vessels and the RI of radial artery and anastomosis between the stenosis group and no complication group(P<0.05). Conclusions: There are some vascular complications in clinically normal AVF patients, which can be monitored with high-frequency ultrasound based on its structure, blood flow volume and hemodynamics measurement regularly. Special emphasis should be put when the blood flow volume is <800 mL/min on ultrasound in order to avoid AVF dysfunction.
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Received: 13 August 2014
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2015, Vol. 26 
