title: Value of duplex ultrasound assistance for thromboaspiration and dilation of thrombosed native arterio-venous fistulae.
abstract: OBJECTIVE
  To evaluate the value of duplex ultrasound assistance during thromboaspiration of thrombosed arteriovenous fistulae for haemodialysis.
  
  
  METHODS
  We prospectively studied 54 thrombosed native fistulae (23 with total thrombosis and 31 with partial thrombosis), in which we performed manual thromboaspiration guided by ultrasonography associated with fluoroscopy.
  
  
  RESULTS
  The fistulae were located in the forearm (n = 39) or in the upper arm (n = 15) of 46 patients. Mean patient age was 65 years, and hypertension was the most common risk factor (74 %). Mean access age was 928 days (range 69-2,290), and most fistulae were on the left side (41 cases, 75.92 %). The success rate was 83 % in the total thrombosis group and 100 % in the partial thrombosis group. Including initial failures, the respective primary patency rates in the total thrombosis group and the partial thrombosis group were, respectively, 83 ± 8 % (n = 20) and 87 ± 6 % (n = 28) at 1 month, 39 ± 10 % (n = 10) and 61 ± 8 % (n = 20) at 6 months, and 17 ± 8 % (n = 5) and 26 ± 8 % (n = 9) at 1 year. The mean decrease of fluoroscopy time with ultrasound was 3 min (range 1-5). The mean decrease of radiation dose was 2.6 Gy cm² (range 0.9-4.3].
  
  
  CONCLUSIONS
  Ultrasound is a feasible and useful tool in the management of thrombosed native fistulae, thus decreasing radiation exposure, and has no detrimental effect on success rates.
authors: Vascular and Interventional Radiology Unit, Department of Radiology, Reina Sophia University Hospital, Calle Intendente Jorge Palacios 1, 30003, Murcia, Spain. josegmedina57@gmail.com.
authors: J
authors: J
authors: García-Medina
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon / Q000379:methods*; D001132:Arm / Q000098:blood supply / Q000000981:diagnostic imaging; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005542:Forearm / Q000098:blood supply / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D011446:Prospective Studies; D006435:Renal Dialysis / Q000295:instrumentation; D013396:Suction / Q000379:methods; D013927:Thrombosis / Q000628:therapy*; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D018084:Ultrasonography, Interventional / Q000379:methods*; D014654:Vascular Patency / Q000502:physiology