title: Invasive radiologic management of hemodialysis fistulas: measuring flow with an endovascular catheter.
abstract: OBJECTIVE
  To analyze the values of flow obtained with an endovascular catheter, and to determine whether they are more reliable than angiographic and clinical findings for planning and for determining the outcome of invasive radiologic treatment of hemodialysis fistulas, as well as to determine the safety of this technique during interventional radiology procedures.
  
  
  METHODS
  We used endovascular catheters to measure flow in 341 vascular accesses for hemodialysis (162 [47.6%] distal fistulas, 132 [38.4%] humeral fistulas, and 47 [14%] arteriovenous grafts) in 598 procedures (a total of 3,051 flow measurements). Dysfunction was most commonly due to high pressures and flow deficits.
  
  
  RESULTS
  The catheter was used to measure the results of radiologic treatment in 419 (70%) cases and only to measure the control of flow in the hemodialysis access in 179 (30%) cases. In the cases where lesions of the access had been treated radiologically, the flow improved by a mean of 1,232ml/min. In 2 (0.35%) cases, the tip of the catheter perforated the wall of the vein; this complication was resolved by inflating a low pressure balloon.
  
  
  CONCLUSIONS
  Endovascular catheters are useful for measuring flow in invasive vascular radiology procedures for hemodialysis. In assessing the hemodynamic status of a vascular access, they are most helpful in determining whether stenosis is present.
authors.affiliation: Sección de Radiología Vascular, Servicio de Radiología, Hospital General Universitario Reina Sofía, Murcia, España. Electronic address: josegmedina57@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: García-Medina
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015642:Radiology, Interventional; D012039:Regional Blood Flow; D006435:Renal Dialysis; D012189:Retrospective Studies; D062666:Vascular Access Devices; D055815:Young Adult
keywords: Acceso vascular; Angioplastia; Angioplasty; Flujo vascular; Hemodialysis; Hemodiálisis; Termodilución; Thermodilution; Ultrasonografía; Ultrasonography; Vascular access; Vascular flow