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The role of Doppler ultrasonography in vascular access surveillance-controversies continue
J. Malik, C. Lomonte, M. Meola, C. de Bont, R. Shahverdyan, JI. Rotmans, F. Saucy, T. Jemcov, J. Ibeas
Language English Country United States
Document type Journal Article, Review
- MeSH
- Arteriovenous Shunt, Surgical * adverse effects MeSH
- Renal Dialysis MeSH
- Ultrasonography, Doppler, Duplex MeSH
- Humans MeSH
- Graft Occlusion, Vascular diagnostic imaging etiology therapy MeSH
- Vascular Patency MeSH
- Ultrasonography MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
Chronic hemodialysis therapy required regular entry into the patient's blood stream with adequate flow. The use of arteriovenous fistulas and grafts is linked with lower morbidity and mortality than the use of catheters. However, these types of accesses are frequently affected by stenoses, which decrease the flow and lead to both inadequate dialysis and access thrombosis. The idea of duplex Doppler ultrasound surveillance is based on the presumption that in-time diagnosis of an asymptomatic significant stenosis and its treatment prolongs access patency. Details of performed trials are conflicting, and current guidelines do not support ultrasound surveillance. This review article summarizes the trials performed and focuses on the reasons of conflicting results. We stress the need of precise standardized criteria of significant access stenosis and the weakness of the metaanalyses performed.
Department of Internal Medicine Leiden University Medical Center The Netherlands
Department of Nephrology Clinical Hospital Centre Zemun Belgrade Serbia
Division of Nephrology Miulli General Hospital Acquaviva delle Fonti Italy
School of Medicine University of Belgrade Belgrade Serbia
Service of Vascular Surgery Department of Heart and Vessels University Hospital Lausanne Switzerland
Vascular Access Clinic Asklepios Clinic Barmbek Hamburg Germany
Vascular Laboratory Bravis Hospital Bergen op Zoom The Netherlands
References provided by Crossref.org
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- $a Chronic hemodialysis therapy required regular entry into the patient's blood stream with adequate flow. The use of arteriovenous fistulas and grafts is linked with lower morbidity and mortality than the use of catheters. However, these types of accesses are frequently affected by stenoses, which decrease the flow and lead to both inadequate dialysis and access thrombosis. The idea of duplex Doppler ultrasound surveillance is based on the presumption that in-time diagnosis of an asymptomatic significant stenosis and its treatment prolongs access patency. Details of performed trials are conflicting, and current guidelines do not support ultrasound surveillance. This review article summarizes the trials performed and focuses on the reasons of conflicting results. We stress the need of precise standardized criteria of significant access stenosis and the weakness of the metaanalyses performed.
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