[Value of vascular ultrasound in the evaluation of hemodialysis fistulas].
Vascular ultrasound has been proven to be effective in the assessment of hemodialysis fistulas providing noninvasive diagnostic work-up of vascular morphology and hemodynamics. The most common reason for hemodialysis fistula failure is thrombosis due to stenosis. Therefore, early identification of stenosis is essential to avoid complications. Ultrasound-based identification of hypoechoic plaques and intimal proliferation helps to reach therapeutic decisions. An estimation of the grade of stenosis is also feasible. An occlusion rate of up to 45% due to reduced blood flow justifies follow-up examinations. Due to frequent puncture of the fistula the risk of hemodynamically relevant stenoses is increased. Establishment of new ultrasound methods like B-flow and advanced dynamic flow (ADF) enable direct visualization of the flow in the area of the anastomosis. In addition, high-resolution ultrasound techniques allow improved flow detection without aliasing. Our report addresses the topics of examination strategy, possible complications, and treatment like percutaneous intervention techniques.
Clevert
D-A
DA
Institut für Klinische Radiologie, Klinikum Grosshadern der Ludwig-Maximilians-Universität München. Dirk.Clevert@med.uni-muenchen.de
Jung
E M
EM
Kubale
R
R
Waggershauser
T
T
Stickel
M
M
Schulte-Altedorneburg
G
G
Kopp
R
R
Reiser
M
M
D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D001808:Blood Vessels / Q000000981:diagnostic imaging*; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000209:etiology*; D006801:Humans; D006435:Renal Dialysis / Q000009:adverse effects*; D014463:Ultrasonography / Q000379:methods*