The Combination of Sonography and Physical Examination Improves the Patency and Suitability of Hemodialysis Arteriovenous Fistula in Vascular Access
- Author:
Normawati Mat Said
;
Kamarul Imran Musa
;
Mohamed Ashraf Mohamed Daud
;
Juhara Haron
- Publication Type:Journal Article
- Keywords:
arteriovenous fistula;
hemodialysis;
ultrasound;
sonography;
vascular patency
- From:Malaysian Journal of Medical Sciences
2016;23(4):26-32
- CountryMalaysia
- Language:English
-
Abstract:
Purpose: We compared the patency and the suitability of arteriovenous fistula (AVF) created
for vascular access by two approaches: (a) physical examination with preoperative vascular mapping
and (b) physical examination alone.
Methods: We compared the patency and the suitability of AVF created in patients for dialysis.
There were two cohorts of patients of 79 patients each: (a) patients with AVF created based on the
combination of physical examination and preoperative vascular mapping (PE+VM) and (b) patients
with AVF created based on physical examination (PE) alone. Fistula patency is defined as clinical
detection of thrill (or auscultation) of murmur over the fistula and coded as having thrills (patent)
versus not having thrills (not patent). Suitability of fistula is defined as functioning AVF (AVF can
be adequately used via 2-needle cannulation for dialysis) and coded as suitable versus not suitable.
Results: AVF created after the preoperative vascular mapping (PE+VM) has 5.70 (at six weeks)
and 3.76 (at three months) times higher chance for patency, and 3.08 times higher chance for suitable
AVF for dialysis than AVF created after the physical examination (PE) alone.
Conclusion: Physical examination with preoperative ultrasound mapping (PE+VM) significantly
improves the short term patency and the suitability of AVF for dialysis.
- Full text:P020160829818694871110.pdf
