title: Value of preoperative sonographic vascular evaluation of haemodialysis access in upperlimb.
abstract: OBJECTIVE
  To know the value of preoperative Dopplerultrasonography vascular mapping of upper limb for hemodialysis access placement.
  
  
  METHODS
  Prospective ultrasonographic assess- ment of upper extremity vessels was performed in 60 patients prior to hemodialysis access placement and potential access sites were selected (based on the standard criteria). The findings were correlated with the operative findings. Discrepancies found between ultrasonographic and operative findings were analysed.
  
  
  RESULTS
  All the 60 patients who underwent vascular mapping had vascular access placed. 80% of them had native arteriovenous fistulae (AVF) placed. In 95% of patients, at the selected sites, the vascular parameters as determined by ultrasonography matched with the operative findings. In 5% of patients there were discrepancies between the ultrasonography findings and operative findings. There was no negative surgical exploration. There was strong correlation between the diameters measured by ultrasonography and surgery.
  
  
  CONCLUSIONS
  Preoperative ultrasonography vascular mapping prior to hemodialysis access placement has facilitated definite selection of potential sites in difficult patient population in whom evaluation by physical examination was inconclusive. It also helped in maximizing the native AVFs and decreasing the negative surgical exploration rates.
authors: Assistant Professor, Department of Radiodiagnosis, K.V.G Medical College & Hospital , Sullia, India .
authors: Aishwarya
authors: A
authors: K C
authors: Professor,Department of Radiodiagnosis, MS Ramaiah Medical College Hospitals , Bangalore, India .
authors: M G
authors: MG
authors: Srinath
authors: Professor, Department of Vascular and Endovascular surgery, MS Ramaiah Medical College Hospitals , Bangalore, India .
authors: Sanjay C
authors: SC
authors: Desai
authors: Professor, Department of Radiodiagnosis, MS Ramaiah Medical College Hospitals , Bangalore, India .
authors: Ashok
authors: A
authors: Kumar A
authors: Associate Professor, Department of Vascular & Endovascular Surgery, MS Ramaiah Medical College Hospitals , Bangalore, India .
authors: Chandrashekar
authors: C
authors: Ar
authors: Assistant Professor, Department of Radiodiagnosis, K.V.G Medical College & Hospital , Sullia, India .
authors: Gowtham
authors: G
authors: Gowda A G
keywords: Arterio-venous fistula; Hemodialysis access placement; Upper limb vascular mapping
references: Kidney Int. 2002 Oct;62(4):1109-24
references: 12234281
references: Nephrol Dial Transplant. 1998 Jan;13(1):125-9
references: 9481727
references: Adv Chronic Kidney Dis. 2009 Sep;16(5):316-20
references: 19695499
references: BMJ. 2006 Mar 11;332(7541):563-4
references: 16528062
references: Am J Kidney Dis. 2002 Jun;39(6):1218-25
references: 12046034
references: J Vasc Surg. 1998 Feb;27(2):302-7; discussion 307-8
references: 9510284
references: Eur J Vasc Surg. 1990 Apr;4(2):179-84
references: 2190848
references: Am J Kidney Dis. 2001 Jan;37(1 Suppl 1):S137-81
references: 11229969
references: J Ultrasound Med. 2004 Feb;23(2):161-8; quiz 169-71
references: 14992353
references: Am J Kidney Dis. 2006 Jul;48 Suppl 1:S248-73
references: 16813991
references: Nephrol Dial Transplant. 2006 Mar;21(3):802-6
references: 16364992
references: J Ultrasound Med. 2006 Dec;25(12):1541-5
references: 17121948
references: Eur J Vasc Endovasc Surg. 1996 Aug;12(2):207-13
references: 8760984
references: J Vasc Surg. 2005 Nov;42(5):957-62
references: 16275454
references: Kidney Int. 2001 Nov;60(5):2013-20
references: 11703621
references: Eur J Vasc Endovasc Surg. 2007 Jan;33(1):113-5
references: 17030130
references: Nephrol Dial Transplant. 2008 Jun;23(6):1809-15
references: 18326561
references: Semin Dial. 2003 Jul-Aug;16(4):299-303
references: 12839503
references: Kidney Int. 2006 Dec;70(12):2131-3
references: 17063176
references: Br J Surg. 2005 Nov;92(11):1439-43
references: 16187267
references: J Nephrol. 2007 May-Jun;20(3):299-303
references: 17557262
references: Am J Kidney Dis. 2001 Sep;38(3):560-4
references: 11532689
references: Nephrol Dial Transplant. 2006 Mar;21(3):715-20
references: 16249200
references: Radiology. 1999 May;211(2):579-83
references: 10228546
references: J Ultrasound Med. 2005 Jun;24(6):829-38; quiz 839-40
references: 15914687