Regular ultrasonographic screening significantly prolongs patency of PTFE grafts
Language English Country United States Media print
Document type Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't
PubMed
15780111
DOI
10.1111/j.1523-1755.2005.00236.x
PII: S0085-2538(15)50614-5
Knihovny.cz E-resources
- MeSH
- Arteriovenous Fistula MeSH
- Blood Vessel Prosthesis * MeSH
- Diabetic Nephropathies therapy MeSH
- Renal Dialysis * MeSH
- Middle Aged MeSH
- Humans MeSH
- Polytetrafluoroethylene * MeSH
- Vascular Patency * MeSH
- Reproducibility of Results MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial MeSH
- Research Support, Non-U.S. Gov't MeSH
- Randomized Controlled Trial MeSH
- Comparative Study MeSH
- Names of Substances
- Polytetrafluoroethylene * MeSH
BACKGROUND: Polytetrafluoroethylene (PTFE) dialysis grafts have considerably shorter patency than native arteriovenous fistulas, despite the use of a complex of screening monitoring methods (venous pressure, access flow). PTFE grafts are used often in subjects with depleted subcutaneous veins after previous abandoned accesses, so keeping the access patent is crucial. We hypothesized that regular duplex Doppler ultrasound screening for access stenoses, together with their sooner treatment, would prolong PTFE graft patency. METHODS: We performed a randomized, prospective study of PTFE grafts' cumulative patency in 192 subjects. In group 1, regular ultrasound examinations performed every 3 months was added to traditional screening (i.e., regular access examination at hemodialysis unit, monitoring of venous pressure and access flow). Group 2 was screened only traditionally (without ultrasound). Interventions of suspected stenoses were indicated by nephrologists, vascular surgeon, and, in group 1, also by ultrasonography. Classic ultrasound criteria for significant stenosis were used, even if the access flow had not been decreased. The mean follow-up lasted 392 +/- 430 days. RESULTS: Groups were similar with respect to age, gender, diabetes status, and number of previous abandoned accesses. Group 1 had significantly longer access patency (P < 0.001). Number of interventions per graft was 2.1 +/- 1.8 and 1.3 +/- 1.0 in group 1 and group 2. CONCLUSIONS: Regular screening duplex Doppler ultrasonography results in significantly longer PTFE graft patency due to early detection of access stenosis and, thus, more frequent elective interventions of access stenoses.
References provided by Crossref.org
Classifications of haemodialysis vascular access stenosis: a scoping review
Arteriovenous Hemodialysis Access Stenosis Diagnosed by Duplex Doppler Ultrasonography: A Review
The role of Doppler ultrasonography in vascular access surveillance-controversies continue
