title: Radiological assessment of vascular access in haemodialysis patients.
abstract: Clinical examination is still the most important diagnostic tool and duplex ultrasonography is the imaging method of first choice. Radiological assessment of vascular access for haemodialysis includes preoperative analysis of vessel anatomy and postoperative surveillance for access maturation as well as diagnosis in vascular access insufficiency. Compared to ultrasonography digital subtraction angiography is superior for the evaluation of the central veins and allows diagnosis and treatment in one session. Computed tomography should only be used in patients with inconclusive ultrasonography results, for example, for the assessment of the central veins and visualization of the vascular tree. Gadolinium-enhanced magnetic resonance imaging is no longer recommended in dialysis patients, because it may trigger nephrogenic systemic fibrosis. In patients with a history of previous central venous catheters additional preoperative imaging of the central veins should be performed. In this article we review the different radiological imaging methods for preoperative assessment and suspected vascular access dysfunction.
authors.affiliation: 1 Department of Diagnostic and Interventional Radiology, HELIOS Klinikum Wuppertal, University Hospital Witten/Herdecke, Wuppertal - Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Kamper
authors.forename: Michael
authors.initials: M
authors.lastname: Frahnert
authors.forename: Scott-Oliver
authors.initials: SO
authors.lastname: Grebe
authors.forename: Patrick
authors.initials: P
authors.lastname: Haage
mesh_terms: D015901:Angiography, Digital Subtraction / Q000009:adverse effects; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D001783:Blood Flow Velocity; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D003287:Contrast Media / Q000009:adverse effects; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D018810:Magnetic Resonance Angiography; D061330:Multidetector Computed Tomography / Q000009:adverse effects; D011237:Predictive Value of Tests; D012039:Regional Blood Flow; D006435:Renal Dialysis; D012307:Risk Factors; D016896:Treatment Outcome; D014654:Vascular Patency
chemical_list: D003287:Contrast Media