Abstract
Vascular access is a hemo-dialysis patient’s lifeline. Two types of permanent vascular access are designed which include the arterio-venous fistula and the arterio-venous graft. After surgical creation, arterio-venous fistulas typically require several months of maturation for the draining vein to dilate and the arterio-venous blood flow to increase. The criteria for AV fistula maturation is vein diameter of 4 mm and access blood flow volume of 500 ml/min by using Doppler. Here we assess the intima-media thickness of the vein in determining maturity of AV fistula.
Purpose- To determine cannulation readiness of AV fistula by determining vein intima-media thickness.
Materials and methods- Institutional review board approval and informed consent were obtained for this study. The study is a cross-sectional study at our hospital tertiary health care set up.
Statistical Analysis – A Chi-square test is used to find an association between variables (gender, diabetic and hypertensive status).
Results and Conclusion- The conclusions drawn are those cases with intima-media thickness </= 0.20 mm are not matured, while those cases with intima-media thickness >/=0.26mm were matured and those cases with intima-media thickness between 0.21-0.25mm were matured only by vein diameter.
KEYWORDS- Intima-media thickness, Vein, maturity, arteriovenous fistula.
References
1. Vascular Access for Hemo-dialysis. [online]. 2014 [cited 2014 Jul 23]; Available from: URL:http://kidney.niddk.-nih.gov/kudiseases/pubs/vascularaccess
2. Umesh Khanna. The economics of dialysis in India. Indian J nephrol2009 Jan;19(1):1-4.
3. Patrick W, Barbara ND. Colour Doppler ultrasound in dialysis access. Nephrol Dial Transplant 2004;19(8):1956-1963.
4. Teodorsu V, Gustavson S, Schanzer H. Duplex ultrasound evaluation of hemodialysis access: A detailed protocol. International Journal of Nephrology [serial online] 2012 [cited 2012 Jun 19]; 2012[7 screens]. Available from: URL:http://-dx.doi.org/10.1155/2012/508956
5. Robbin ML, Chamberlain NE, Lockhart ME, Gallichio MH, Young CJ, Deierhoi MH et al. Hemodialysis arteriovenous fistula maturity: US evaluation. Radiology 2002 Oct;225(1):59-64.
6. CemY, SunaO, YaseminE, AykutB, HakanO. B- flow sonographic evaluation of hemodialysis fistulas. J Ultrasound Med 2005;24:1503-1508.
7. Couto TMO, Matos H, Moreira A, Estevao A.Ultrasound and the dialysis patient. European Congress of Radiology.2011 Mar; Wein.
8. Paul LA, Paul AD, Myron AP, Norman W. Clinical Doppler ultrasound. China:Elsevier; 2006. 79-80.
9. Paul LA, Paul AD, Myron AP, Norman W. Clinical Doppler ultrasound. China: Elsevier; 2006. 109-111.
10. Singh P, Robbin ML, Lockhart ME, Allon M. Clinically Immature Arteriovenous hemodialysis fistulas: Effect of US on salvage. Radiology 2008 Jan;246(1):299-305.
11. Kaushal L, Patil A, Verma VK, Ahirwar CP, Shamim. Vascular mapping before hemodialysis Access in CRF patients and Evaluation of AVF maturation by Doppler Ultrasound. Sch J App Med Sci 2014;2(3A):949-955.
12. Arash J, Derek M, Rosa MM, Niki D, Adrien B. Arteriovenous Fistulas for Hemodialysis: Application of High Frequency US to Assess Vein Wall Morphology for Cannulation Readiness. Radiology 2011 Nov;261(2):616-624.
13. David EF, Deborah GL, Mary CF, Janis GL.Duplex and ColorDoppler Sonography of HemodialysisArteriovenous Fistulas and Grafts. Radiographics 1993; 13:983-999.
14. RobbinML.,GreeneT,Cheung AK, Allon M, Berceli SA et al. Arteriovenous Fistula Development in the First 6 Weeks after Creation.Radiology 2016 May; 279:620–629.
DOI: https://dx.doi.org/10.18535/jmscr/v4i11.21
