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KMID : 1147320160030010007
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Journal of Surgical Ultrasound
2016 Volume.3 No. 1 p.7 ~ p.12
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Ultrasonographic Evaluation of Hemodialysis Access
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Park Byung-Wook
Kim Hyang-Kyoung
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Abstract
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Maintaining patency of vascular access is of great importance in ensuring adequate dialysis in chronic kidney disease patients, and subsequent complications of access represent a major cause of morbidity, hospitalization, and cost of intervention or surgery. Duplex ultrasound is a key technique currently employed for investigation of access related problems. Its reliability and accuracy is comparable with that of conventional angiography. It is used as a preoperative tool in assessment of arterial and venous anatomy and in making surgical decisions. In the pre-dialysis fistula, it provides information on maturation status and the causes of immaturity if the fistula is not adequate for dialysis. In ongoing access surveillance, it defines the nature, location, and severity of the problem, such as stenosis, pseudoaneurysm, aneurysm, steal syndrome, and venous hypertension, enabling the planning of endovascular or open surgical treatment. Stenosis, the most common problem, can be assessed using PSV (peak systolic velocity), PSV ratio, and volume flow.
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KEYWORD
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Ultrasound, Hemodialysis access, Maturation, Stenosis
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