Physical Examination of Dialysis Vascular Access and Vascular Access Surveillance

2014 ◽  
pp. 83-97
Author(s):  
Chieh Suai Tan ◽  
David J. R. Steele ◽  
Steven Wu
Keyword(s):  
Physical Examination ◽  
Vascular Access

Preoperative Physical Examination for Primary Vascular Access — Reliability in Determining Vessel Quality

2006 ◽  
Vol 106 (5) ◽  
pp. 554-559
Author(s):  
V. Suominen ◽  
M. Heikkinen ◽  
L. Keski-Nisula ◽  
J. Saarinen ◽  
J. Virkkunen ◽  
...  
Keyword(s):  
Physical Examination ◽  
Vascular Access

Quantitative physical examination indicators to detect patients with stenosis at a high risk of thrombosis at hemodialysis vascular access sites: A retrospective case–control study

2021 ◽  
pp. 112972982110455
Author(s):  
Matt Chiung-Yu Chen ◽  
Mei-Jui Weng ◽  
Lee-Hua Chao ◽  
Misoso Yi-Wen Wu ◽  
Yi-Chun Liu ◽  
...  
Keyword(s):  
High Risk ◽  
Physical Examination ◽  
Vascular Access ◽  
Case Control Study ◽  
Case Control ◽  
Retrospective Case ◽  
Luminal Diameter ◽  
Predictive Values ◽  
Hemodialysis Vascular Access ◽  
Control Study

Background: Quantitative physical examination (PE) indicators, including palpable pulsatility length and outflow scores, can be used to quantify stenosis severity at hemodialysis vascular access sites. It is known that the risk of high-shear-related thrombosis is increased when the minimal luminal diameter (MLD) of stenosis decreases. At present, MLD is measured using sonography or angiography. This study sought to determine the relationship between quantitative PE indicators and MLD and report their diagnostic performance in detecting patients with stenosis at a high risk of thrombosis. Methods: We performed a retrospective case–control study using routinely collected data. We used the post-stenosis palpable pulsatility length (sPPL) and pulse-and-thrill based outflow score to assess the severity of AVF inflow and outflow stenosis, respectively. We recorded paired quantitative PE indicators and MLD before and after angioplasty in patients enrolled over a 4-month period. Results: A total of 249 paired PE indicators and MLD measurements were obtained from 163 patients. A receiver operating characteristic curve analysis showed that an MLD cutoff value of <1.55 mm and an MLD of <1.95 mm discriminated sPPL = 0 and PESOS (physical examination significant outflow stenosis)/1− of the outflow score, respectively, from all other measurements, with the area under the curve values of 0.8922 and 0.9618, respectively. With sPPL = 0 and PESOS/1− of the outflow score as diagnostic tools to detect inflow stenosis with an MLD of ⩽1.5 mm and outflow stenosis with an MLD of ⩽1.9 mm at vascular access sites, sensitivity = 86.00% and 88.46%; specificity = 97.67% and 92.11%; positive predictive values of 97.73% and 92.00% and negative predictive values of 85.71% and 88.61%, respectively, were observed. Conclusions: Our preliminary results showed that physical examination can potentially be a diagnostic tool in detecting patients with stenosis who are at a high risk of thrombosis at hemodialysis vascular access sites with high diagnostic accuracy.

Assessment of Occlusion of the Vascular Access in Patients on Chronic Hemodialysis: Comparison of Physical Examination with Continuous-Wave Doppler Ultrasound

Nephron ◽  
1999 ◽  
Vol 82 (1) ◽  
pp. 7-11 ◽  
Author(s):  
Rino Migliacci ◽  
Maria Laura Selli ◽  
Francesca Falcinelli ◽  
Lorenza Vandelli ◽  
Egidio Lusvarghi ◽  
...  
Keyword(s):  
Physical Examination ◽  
Doppler Ultrasound ◽  
Vascular Access ◽  
Continuous Wave ◽  
Chronic Hemodialysis ◽  
Continuous Wave Doppler

scholarly journals Our experience of arteriovenous fistula creation as vascular access for hemodialysis

2020 ◽  
Vol 7 (7) ◽  
pp. 2321
Author(s):  
Pradeep K. Sharma ◽  
Rupesh Nagori ◽  
Shekhar Baweja ◽  
Vikas Aggarwal ◽  
Pawan Katti ◽  
...  
Keyword(s):  
Physical Examination ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Color Doppler ◽  
Postoperative Outcome ◽  
Arterial System ◽  
Dominant Hand ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Background: End stage renal disease (ESRD) patients depend on lifelong renal replacement therapy. The arteriovenous fistula (AVF) is the preferred hemodialysis access. Cimino fistulas are currently accepted as the best mode of vascular access for hemodialysis (HD). The present study was planned to study for presence of on table bruit and thrill and to know postoperative outcome and patency.Methods: This single center, prospective study was carried out in department of Urology at SNMC, Jodhpur from November 2018 to May 2019.  Dominance of hand was examined, and preference was given to non-dominant hand. Physical examination of the arterial system along with physical examination of the venous system was done.  Preoperative color Doppler of upper limb veins and arteries was done in selected patients. End to side anastomosis was done between cephalic vein and radial artery.Results: In this study of 70 cases of AVFs, there were 53 (75.71%) successful cases and 17 (24.2%) were failures.  End (vein) to side (artery) anastomosis was done in 70 (100%) cases.  On table bruit was present in 63 (90%) and thrill in 58 (82.8%) cases. All patients with failed post-operative fistula were not doing ball exercise.Conclusions: Presence of on table thrill and bruit are indicators of successful AVF. Post-operative ball exercise should be done for better results.

Physical Examination of Dialysis Vascular Access and Vascular Access Surveillance

2021 ◽  
pp. 85-94
Author(s):  
Ru Yu Tan ◽  
Chieh Suai Tan ◽  
David J. R. Steele ◽  
Steven Wu
Keyword(s):  
Physical Examination ◽  
Vascular Access

Tools and Resources: Web Sites of Interest

2001 ◽  
Vol 6 (2) ◽  
pp. 6-8
Author(s):  
Christopher R. Brigham
Keyword(s):  
Informed Consent ◽  
Physical Examination ◽  
Functional Status ◽  
Web Sites ◽  
Satisfaction Survey ◽  
High Quality ◽  
Diagnostic Studies ◽  
Physician Relationship ◽  
Complete History

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, explains that independent medical evaluations (IMEs) are not the same as impairment evaluations, and the evaluation must be designed to provide the data to answer the questions asked by the requesting client. This article continues discussions from the September/October issue of The Guides Newsletter and examines what occurs after the examinee arrives in the physician's office. First are orientation and obtaining informed consent, and the examinee must understand that there is no patient–physician relationship and the physician will not provide treatment bur rather will send a report to the client who requested the IME. Many physicians ask the examinee to complete a questionnaire and a series of pain inventories before the interview. Typical elements of a complete history are shown in a table. An equally detailed physical examination follows a meticulous history, and standardized forms for reporting these findings are useful. Pain and functional status inventories may supplement the evaluation, and the examining physician examines radiographic and diagnostic studies. The physician informs the interviewee when the evaluation is complete and, without discussing the findings, asks the examinee to complete a satisfaction survey and reviews the latter to identify and rectify any issues before the examinee leaves. A future article will discuss high-quality IME reports.

Sign in / Sign up

Export Citation Format

Share Document