title: Systematic evaluation of vascular access by color-Doppler ultrasound decreased the incidence of emergent vascular access intervention therapy and X-ray exposure time: a single-center observational study.
abstract: Arteriovenous fistula has superior patency over other accesses, but vascular access intervention therapy (VAIVT) for stenosis or thrombosis still remain major reasons for hospital admission of dialysis patients. The aim of this study was to examine the usefulness of systematic evaluation of vascular access by color-Doppler ultrasound (CDUS). This study was a single-center observational design study. We planned screening CDUS to evaluate all vascular accesses once per year, and additionally, follow-up CDUS of post-interventional patients 1 month, 3 months and 6 months after their recent VAIVT. This systematic evaluation was started from September 2009. The observational period between September 2008 and August 2009 was defined as period A. The observational period between September 2009 and August 2010 was defined as period B. We compared the incidence of emergent VAIVT and X-ray exposure time during the period A to B. 131 patients with AV fistula were assigned. 13 patients were excluded due to death, hospital transfer or re-operation of their accesses. During period A, 57 VAIVTs were carried out, and 37 cases (65%) were emergent. During period B, 42 VAIVTs were carried out, and 11 cases (25%) were emergent. The incidence of emergent intervention therapy was lower during period B than period A (P < 0.001). The amount of X-ray exposure time per patient was decreased in patients who received VAIVT during both periods (P < 0.03). Systematic evaluation of vascular access by CDUS decreased the incidence of emergent VAIVT and X-ray exposure time.
authors.affiliation: Departments of Nephrology and Hypertension Department of Cardiology, Mitsubishi Kyoto Hospital, Kyoto, Japan. smatsui-kob@umin.ac.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Matsui
authors.forename: Kentaro
authors.initials: K
authors.lastname: Nakai
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Taniguchi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Nagai
authors.forename: Takafumi
authors.initials: T
authors.lastname: Yokomatsu
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kono
authors.forename: Tetsu
authors.initials: T
authors.lastname: Mizoguchi
authors.forename: Shinji
authors.initials: S
authors.lastname: Miki
authors.forename: Akira
authors.initials: A
authors.lastname: Yoshida
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nagao
authors.forename: Hiroko
authors.initials: H
authors.lastname: Tsuji
authors.forename: Shinji
authors.initials: S
authors.lastname: Ono
mesh_terms: D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019370:Observation; D006435:Renal Dialysis; D018615:Ultrasonography, Doppler, Color; D062666:Vascular Access Devices; D014654:Vascular Patency