title: The Combination of Sonography and Physical Examination Improves the Patency and Suitability of Hemodialysis Arteriovenous Fistula in Vascular Access.
abstract: OBJECTIVE
  We compared the patency and the suitability of arteriovenous fistula (AVF) created for vascular access by two approaches: (a) physical examination with preoperative vascular mapping and (b) physical examination alone.
  
  
  METHODS
  We compared the patency and the suitability of AVF created in patients for dialysis. There were two cohorts of patients of 79 patients each: (a) patients with AVF created based on the combination of physical examination and preoperative vascular mapping (PE+VM) and (b) patients with AVF created based on physical examination (PE) alone. Fistula patency is defined as clinical detection of thrill (or auscultation) of murmur over the fistula and coded as having thrills (patent) versus not having thrills (not patent). Suitability of fistula is defined as functioning AVF (AVF can be adequately used via 2-needle cannulation for dialysis) and coded as suitable versus not suitable.
  
  
  RESULTS
  AVF created after the preoperative vascular mapping (PE+VM) has 5.70 (at six weeks) and 3.76 (at three months) times higher chance for patency, and 3.08 times higher chance for suitable AVF for dialysis than AVF created after the physical examination (PE) alone.
  
  
  CONCLUSIONS
  Physical examination with preoperative ultrasound mapping (PE+VM) significantly improves the short term patency and the suitability of AVF for dialysis.
authors.affiliation: Department of Radiology, Universiti Sains Malaysia Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia.
authors.forename: Normawati
authors.initials: N
authors.lastname: Mat Said
authors.affiliation: Department of Community Medicine, Universiti Sains Malaysia Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia.
authors.forename: Kamarul Imran
authors.initials: KI
authors.lastname: Musa
authors.affiliation: Department of Surgery, Universiti Sains Malaysia Health Campus 16150, Kubang Kerian, Kelantan, Malaysia.
authors.forename: Mohamed Ashraf
authors.initials: MA
authors.lastname: Mohamed Daud
authors.affiliation: Department of Radiology, Universiti Sains Malaysia Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia.
authors.forename: Juhara
authors.initials: J
authors.lastname: Haron
keywords: arteriovenous fistula; hemodialysis; sonography; ultrasound; vascular patency