[Duplex ultrasound determination of shunt volume in iatrogenic arteriovenous fistulas after heart catheterization].
OBJECTIVE
To determine the shunt volume of iatrogenic arteriovenous fistula (AVF) following arterial puncture of the groin and to evaluate its impact on natural history and clinical outcome.


METHODS
Over a period of 12 months, 22 patients (p) with a newly acquired AVF were followed up. The arteriovenous shunt volume was determined by means of colored duplex- and doppler sonography immediately after diagnosis of AVF.


RESULTS
Spontaneous closure of AVF was seen in 10 p (46%) during follow-up examination, whereas 12 p (54%) showed a persistence of their AVF. The median (I50) shunt volume of closed AVF was 310 (250-350) ml/min and 350 (160-510) ml/min for persistent fistulae (p = ns). A shunt volume of > or = 400 ml/min was determined as a significant (p < or = 0.05) cut-off point for prolonged persistence of AVF.


CONCLUSIONS
Because spontaneous closure of AVF was 46% in the course of the first year, conservative management with regular duplex control seems to be justified at least for this duration. Patients with a shunt volume of > or = 400 ml/min have an increased risk of prolonged AVF persistence and therefore should be included in long-term follow-up with special attention to development of hemodynamic relevance.
Perings
S M
SM
Medizinische Klinik und Poliklinik B Klinik für Kardiologie, Angiologie und Pneumologie Moorenstrasse 5 40225 Düsseldorf, Germany. perings@uni-duesseldorf.de
Kelm
M
M
Lauer
Th
T
Strauer
B E
BE
D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001783:Blood Flow Velocity / Q000502:physiology; D001810:Blood Volume / Q000502:physiology*; D006328:Cardiac Catheterization / Q000009:adverse effects*; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000293:injuries*; D005268:Femoral Vein / Q000000981:diagnostic imaging / Q000293:injuries*; D005500:Follow-Up Studies; D006801:Humans; D007049:Iatrogenic Disease; D012075:Remission, Spontaneous; D018615:Ultrasonography, Doppler, Color