title: A systematic review of preoperative duplex ultrasonography and arteriovenous fistula formation.
abstract: BACKGROUND
  Arteriovenous fistula (AVF) formation for dialysis access is a common procedure. Fistula maturation is unpredictable. Preoperative duplex mapping may increase procedural success. We undertook a systematic review to assess the effect of preoperative duplex mapping on subsequent AVF patency.
  
  
  METHODS
  The published literature was searched on PubMed and the Cochrane Library using the following keywords: 'arteriovenous fistula,' 'venous mapping,' 'ultrasound,' 'hemodialysis,' 'vascular access,' and 'perioperative vessel mapping.' Conference proceedings were hand searched for otherwise unpublished trials. Only randomized controlled trials in which preoperative duplex mapping was compared with clinical evaluation were eligible.
  
  
  RESULTS
  Three trials (402 patients) were identified. More patients who underwent ultrasound successfully started using their fistula for dialysis access, although the difference did not reach statistical significance (174/214 vs 130/188; pooled odds ratio, 1.96; P = .11).
  
  
  CONCLUSIONS
  Preoperative duplex mapping may improve fistula maturation rates. However, the results do not reach statistical significance and there are no cost-effectiveness data. Further work is required.
authors.affiliation: Department of Vascular Surgery, University Hospital Limerick, Limerick, Ireland.
authors.forename: Chee Siong
authors.initials: CS
authors.lastname: Wong
authors.forename: Nuala
authors.initials: N
authors.lastname: McNicholas
authors.forename: Donagh
authors.initials: D
authors.lastname: Healy
authors.forename: Mary
authors.initials: M
authors.lastname: Clarke-Moloney
authors.forename: J Calvin
authors.initials: JC
authors.lastname: Coffey
authors.forename: Pierce A
authors.initials: PA
authors.lastname: Grace
authors.forename: Stewart R
authors.initials: SR
authors.lastname: Walsh
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D006801:Humans; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011300:Preoperative Care; D006435:Renal Dialysis; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014654:Vascular Patency