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Frequency of critical stenosis in primary arteriovenous fistulae before hemodialysis access: Should duplex ultrasound surveillance be the standard of.

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Presentation on theme: "Frequency of critical stenosis in primary arteriovenous fistulae before hemodialysis access: Should duplex ultrasound surveillance be the standard of."— Presentation transcript:

1 Frequency of critical stenosis in primary arteriovenous fistulae before hemodialysis access: Should duplex ultrasound surveillance be the standard of care?  Jennifer Grogan, MD, Maria Castilla, BS, RVT, Laurie Lozanski, BS, RVT, Andrea Griffin, RDMS, Frank Loth, PhD, Hisham Bassiouny, MD  Journal of Vascular Surgery  Volume 41, Issue 6, Pages (June 2005) DOI: /j.jvs Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

2 Fig 1 Color duplex ultrasound (CDU) and B-mode findings of venous stenosis in the mid-segment of the venous outflow of a brachiobasilic transposition primary arteriovenous fistula. A, CDU velocity profiles: peak systolic velocity (PSV) at stenosis = 227 cm/s and PSV prestenosis = 85 cm/s. Systolic velocity ratio = 2.7, indicating a luminal stenosis ≥50%. B, B-mode ultrasound assessment of venous stenosis demonstrating focal valve leaflet thickening. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

3 Fig 2 Radiocephalic fistulogram demonstrates a ≥50% arterial stenosis. Color duplex ultrasound (CDU) examination demonstrates a hemodynamically significant abnormality at the anastomosis. CDU velocity profiles: peak systolic velocity (PSV) at anastomosis = 438 cm/s and PSV prestenosis = 130 cm/s. Systolic velocity ratio = 3.4. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

4 Fig 3 Brachiobasilic transposition fistulogram demonstrates a ≥50% anastomotic stenosis (C). Color duplex ultrasound (CDU) velocity profiles: peak systolic velocity (PSV) at arterial inflow = 185 cm/s (A), PSV at anastomosis = 711 cm/s, and systolic velocity ratio = 3.8, indicating an anastomotic stenosis (B). Inset shows color flow mapping for the anastomotic region. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

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