BACKGROUND: Use of routine preoperative ultrasonography to determine the optimum site for haemodialysis access surgery increases the number of distal arteriovenous fistulas formed and improves overall patency rates. Nevertheless its use in all patients is time consuming and costly. This study examined whether clinical parameters could be used to determine the requirement for preoperative ultrasonography. METHODS: Between March 2002 and October 2003, 145 consecutive patients were reviewed in the vascular access clinic. Patients were first assessed clinically, a site for vascular access surgery was proposed, and the need for radiological mapping studies recorded. A second, blinded, clinician determined the site for vascular access surgery using ultrasonography. The correlation between clinical and ultrasonographic findings was then examined. RESULTS: Ultrasonography was considered unnecessary using clinical criteria in 106 patients. Subsequent ultrasonographic mapping altered the management of only one patient. In contrast, the management of 18 of the 39 patients in whom ultrasonography was thought necessary was influenced by radiological imaging. A 1-year primary patency rate of 77.0 per cent was achieved following vascular access surgery on the study population. CONCLUSION: Clinical parameters could be used to determine the need for preoperative vascular ultrasonographic mapping; imaging was not required in the majority of patients.
BACKGROUND: Use of routine preoperative ultrasonography to determine the optimum site for haemodialysis access surgery increases the number of distal arteriovenous fistulas formed and improves overall patency rates. Nevertheless its use in all patients is time consuming and costly. This study examined whether clinical parameters could be used to determine the requirement for preoperative ultrasonography. METHODS: Between March 2002 and October 2003, 145 consecutive patients were reviewed in the vascular access clinic. Patients were first assessed clinically, a site for vascular access surgery was proposed, and the need for radiological mapping studies recorded. A second, blinded, clinician determined the site for vascular access surgery using ultrasonography. The correlation between clinical and ultrasonographic findings was then examined. RESULTS: Ultrasonography was considered unnecessary using clinical criteria in 106 patients. Subsequent ultrasonographic mapping altered the management of only one patient. In contrast, the management of 18 of the 39 patients in whom ultrasonography was thought necessary was influenced by radiological imaging. A 1-year primary patency rate of 77.0 per cent was achieved following vascular access surgery on the study population. CONCLUSION: Clinical parameters could be used to determine the need for preoperative vascular ultrasonographic mapping; imaging was not required in the majority of patients.
Authors: Eoin A Murphy; Rose A Ross; Robert G Jones; Stephen J Gandy; Nicolas Aristokleous; Marco Salsano; Jonathan R Weir-McCall; Shona Matthew; John Graeme Houston Journal: Cardiovasc Eng Technol Date: 2017-07-13 Impact factor: 2.495
Authors: James Richards; Mohammed Hossain; Dominic Summers; Matthew Slater; Matthew Bartlett; Vasilis Kosmoliaptsis; Edward Cf Wilson; Regin Lagaac; Anna Sidders; Claire Foley; Emma Laing; Valerie Hopkins; Chloe Fitzpatrick-Creamer; Cara Hudson; Helen Thomas; Sam Turner; Andrew Tambyraja; Subash Somalanka; James Hunter; Sam Dutta; Sarah Lawman; Tracey Salter; Mohammed Aslam; Atul Bagul; Rajesh Sivaprakasam; George Smith; Zia Moinuddin; Simon Knight; Paul Gibbs; Reza Motallebzadeh; Nicholas Barnett; Gavin Pettigrew Journal: BMJ Open Date: 2019-07-23 Impact factor: 2.692
Authors: Sung Min Kim; Youngjin Han; Hyunwook Kwon; Hee Sun Hong; Ji Yoon Choi; Hojong Park; Tae-Won Kwon; Yong-Pil Cho Journal: Ann Surg Treat Res Date: 2016-03-30 Impact factor: 1.859