Hemodialysis AV Fistula: What a Radiologist Should Know?

Mapping Intimacies ◽

10.5772/intechopen.100485 ◽

2021 ◽

Author(s):

Vaidehi A. Patel

Keyword(s):

Surgical Technique ◽

Vascular Access ◽

End Stage Renal Disease ◽

Color Doppler ◽

Av Fistula ◽

Doppler Study ◽

Operative Evaluation ◽

Vascular Mapping ◽

Stage Renal Disease ◽

End Stage

Hemodialysis works as a lifeline for end stage renal disease patients. Creation and maintenance of vascular access for dialysis is the mammoth task. Due to increased references related to vascular access; number of complications are faced in pre as well as post operative period of vascular access creation. Ultrasound and color Doppler study play a major role in imaging throughout this period. Pre operative vascular mapping is very crucial to help surgeon to determine the proper site and surgical technique for vascular access creation. Early and delayed post operative complications can also be diagnosed with ultrasound and color Doppler study. Here we have tried to cover all the important points which a radiologist should consider during pre operative vascular mapping and post operative evaluation of vascular access as well as any associated complications.

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A Comparative Study between Radiocephalic and Brachiocephalic Arteriovenous Fistula in End Stage Renal Disease

Cardiovascular Journal ◽

10.3329/cardio.v14i1.55373 ◽

2021 ◽

Vol 14 (1) ◽

pp. 44-49

Author(s):

Md Nazmus Sabah ◽

SM Parvez Ahmed ◽

Md Saif Ullah Khan ◽

Rakibul Hasan ◽

Md Fidah Hossain ◽

...

Keyword(s):

Renal Disease ◽

End Stage Renal Disease ◽

Color Doppler ◽

Maturation Time ◽

Doppler Study ◽

Group I ◽

Group Ii ◽

The Difference ◽

Stage Renal Disease ◽

End Stage

Background: Chronic Kidney Disease (CKD) is a major health issue all over the world. Patients with deteriorating renal function and end-stage renal disease require vascular access for hemodialysis. Studies suggest that Arterio-Venous fistula (AVF) constructed judiciously using autologous conduit give the best outcome in this regard. Objective of the study was to compare the outcomes of Radiocephalic and Brachiocephalic AVF in end stage renal disease (ESRD). Methods: It was a quasi-experimental study carried out at the Department of Vascular Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. The study was conducted from June 2019 to May 2020. Patients suffering from ESRD underwent AVF creation surgery for hemodialysis access. A total of 60 (Sixty) patients were included in this study. The patients were divided into two groups; Group I included 30 patients who underwent Radiocephalic AVF operation and Group II included 30 patients who had Brachiocephalic AVF operation. Results: In Group I, (Radiocephalic AVF) 60% were male and 40% were female. On the other hand, in Group II (Brachiocephalic AVF) 73.3% were male and 26.7% were female. Calculated volume flow (Q max) was significantly higher in Group II compared with Group I (769.11±101.54 ml/min vs 626.37±55.81) ml/min) with the difference being statistically significant (P=0.001). Maturation time was significantly less in Group II compared with Group I )37.78±1.93 vs 43.33±2.12 days) with the difference between the two group being statistically significant (P=0.001). Complication was more in Group I than Group II (16.7% vs 3.3%). Conclusion: The present study shows that Brachiocephalic AVF gives significantly better outcome in terms of shorter maturation time and less complications compared with Radio-Cephalic AVF. Color Doppler study is an essential tool for preoperative vessel evaluation which guides the selection of suitable AVF construction site. Cardiovasc j 2021; 14(1): 44-49

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Comparative Study of Autologous Radiocephalic and Brachiocephalic Arteriovenous Fistula in Patients with End Stage Renal Disease

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v18i1.35206 ◽

2020 ◽

Vol 18 (1) ◽

pp. 78-81

Author(s):

Deepak Thapa Magar ◽

Kiran Shrestha ◽

Dinesh Chapagain ◽

Kumar Shrestha ◽

Sara Thapa

Keyword(s):

Renal Disease ◽

Arteriovenous Fistula ◽

Failure Rate ◽

Vascular Access ◽

End Stage Renal Disease ◽

Patency Rate ◽

Av Fistula ◽

Number Of Patients ◽

Stage Renal Disease ◽

End Stage

Introduction: End-stage renal disease requires treatment with dialysis or renal transplantation. For the dialysis, autologous radiocephalic (RC) or brachiocephalic (BC) arteriovenous fistula (AVF) is the better option for vascular access for hemodialysis. Aims: The aim of this study is to find out the outcome between RC AVF and BC AVF. Methods: This is the retrospective study, conducted for the period of 24 months from September 2017 to September 2019 in the department of Cardiothoracic and Vascular Surgery of Bir Hospital, Nepal. RC and BC AVF were created for the assess of hemodialysis. Outcome and different complications were taken into consideration. Results: The total number of patients included in this study was 400. The overall failure rate of autologous AV fistula was 12.75%. Out of these, the failure rate was more in RC AV fistula group, 34 (17%) than in BC AV fistula group, 17 (8.5%). The most common complication was bleeding in both groups having an overall rate of 39 (9.75%). The limb edema was more common in BC AV fistula group 16 (8.0%) then in RC AV fistula group 7(3.5%). The overall infection rate was 4.5%. Overall patency rate was 87.25%. Conclusion: Autologous RC AVF and BC AVF are the choices for vascular access for hemodialysis in patients with end-stage renal disease. BC AVF has a better patency rate than RC AVF but with the slight higher risk of complications.

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Spectrum of vascular abnormalities in color Doppler examination of upper extremities tested for suitability for AV fistula creation in patients of renal failure

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20170029 ◽

2017 ◽

Vol 4 (1) ◽

pp. 47

Author(s):

Seema Grover ◽

Suprabhat Bolisetti ◽

Shailesh Sangani ◽

Sonali Gadhavi ◽

Neeraja Kulkarni

Keyword(s):

Renal Disease ◽

Success Rate ◽

End Stage Renal Disease ◽

Upper Extremities ◽

Upper Limbs ◽

Av Fistula ◽

Vascular Abnormalities ◽

Doppler Study ◽

Stage Renal Disease ◽

End Stage

Background: Almost all patients with end stage renal disease require haemodialysis at some stage of their disease and arteriovenous fistula is the most convenient option. The purpose of this study was to analyse the prevalence of vascular abnormalities in the upper limbs of patients posted for creation of haemodialysis access. Knowledge of the variant anatomy of upper limb vessels helps in better planning of surgery, avoiding unnecessary surgery and improving the success rate of haemodialysis access creation.Methods: This study is a retrospective analysis of colour Doppler study of 150 upper extremities of end stage renal disease patients posted for AV fistula creation. The limbs were evaluated for arterial and venous anatomy rendering them fit or unfit for fistula creation.Results: We found abnormal vasculature in more than 60% of the upper limbs. Congenital arterial abnormality was found in 9 % of upper limbs and venous abnormality was found in 65 % of upper limbs. Unnecessary surgery could be avoided in approximately 74 % of patients. 10 % had correctable abnormality.Conclusions: Pre-operative ultrasound and Doppler assessment resulted in more patients being subjected to proximal fistulas and alternate suitable dialysis processes like permcath or peritoneal dialysis. Primary fistula success rate obtained by this pre-operative evaluation was close to 95 %.

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