Efficiency of color doppler ultrasonography for assessment of maturation and post-operative dysfunction of hemodialysis arteriovenous fistula

 

Mohammed Hazem^1,2

 

¹Department of Surgery, Faculty of Medicine, King Faisal University, Hofuf, SAUDI ARABIA.

²Department of Radiology, Sohag Faculty of Medicine, Sohag University, Sohag, EGYPT.

 

Abstract              Background: In the last decades the incidence of chronic renal failure was increased with subsequent increase the need for permanent hemodialysis arterio-venous fistula. The long-term survival of patients on hemodialysis (HD) is dependent on adequate hemodialysis which depends on quality and degree of functionality of vascular access Color Doppler Ultrasound is safe, inexpensive, rapid, and repeatable imaging modality used for preoperative mapping and post operative diagnosis of vascular access (VA) complications. The aim of our study is to detect the efficiency of Color Doppler ultrasonography in evaluation of AVF. Materials and Methods: Between May 2017 and July 2018, 45 patients with chronic renal failure who went AVF were evaluated using Color Duplex-Doppler ultrasound preoperatively as well as on 7th day, 14th day, first, second and third months post operatively for both maturation and complications. Results: Our study demonstrated that about 50 % of hemodialysis arterio-venous fistulas reach maturation by the end of the first week and all reach maturation by the end of the first month. 31 patients in our study are non complicated and pass safe (68.9 %) while 14 patients had complication (31.1%) "Thrombosis 11.11 % (5 patients), stenosis 8.89 % (4 patients), aneurysmal formation 4.44 % (2 patients), infection 4.44 % (2 patients) and venous hypertension 2.22 % (1 patients). Discussion and Conclusion: Color Doppler ultrasound is safe, non-invasive, bed-side technique, low cost and available imaging tool that allows accurate anatomical and hemodynamical data, that is very helpful in preoperative mapping as a for HAVF creation, assessment of maturation time and subsequent availability for use, as well as early detection of complications either by the morphological or hemodynamic changes.

Keywords: Vascular access, End Stage renal disease, Ultrasound, Graft, Color Doppler ultrasound, Artero-venous fistula, Hemodialysis