Utility of doppler ultrasound in the preoperative evaluation of the first vascular access for haemodialysis

Eduardo Mateos Torres, Silvia Collado Nieto, Higini Cao Baduell, Mónica Lacambra Peñart, Alina Velescu, Albert Clará Velasco

    Research output: Contribution to journalArticleResearch

    Abstract

    Copyright © 2019 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved. INTRODUCTION: Traditionally, the indication of the type of vascular access (VA) has been based on the surgeon's physical examination, but it is now suggested that imaging methods could provide a clinical benefit. Our aim was to determine whether or not preoperative Doppler ultrasound modifies outcomes of the first VA for haemodialysis. PATIENTS AND METHODS: Prospective cohort of patients undergoing a first VA from June 2014 to July 2017 who had a preoperative Doppler ultrasound (ECO group). They were compared to a historical cohort (January 2012-May 2014) of first VA indicated exclusively by clinical assessment (CLN group). RESULTS: A total of 86 patients from the CLN group were compared to 92 from the ECO group, which was younger (68.4 vs 64.0, P=.038). The primary patency (CLN/ECO) at 1 and 2years was 59.5%/71.9% and 53.1%/57.8% respectively, marginally better in the ECO group (P=.057). The assisted patency at 1 and 2years was 63.2%/80.7% and 58.1%/70.2%, respectively, significantly better for the ECO group (P=.010). Due to lack of patency/utility of the initial VA, 26.7% in the CLN group and 7.6% in the ECO group (P<.001) required a new VA during the first 6months. An average of 1.39 interventions were performed to achieve a useful VA in the CLN group and 1.08 in the ECO group (P<.001), the first VA being useful at the radiocephalic level in 31.0%/45.1% (P=.039). CONCLUSION: The indication of the first VA according to a preoperative Doppler ultrasound examination could decrease the need for new VA, enable them to be made more distal, and significantly improve patency.
    Original languageEnglish
    Pages (from-to)539-544
    JournalNefrologia : publicacion oficial de la Sociedad Espanola Nefrologia
    Volume39
    DOIs
    Publication statusPublished - 1 Sep 2019

    Keywords

    • Acceso vascular
    • Arteriovenous fistulae
    • Doppler ultrasound
    • Ecografía doppler
    • Fístula arteriovenosa
    • Haemodialysis
    • Hemodiálisis
    • Patency
    • Permeabilidad
    • Vascular access

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