PURPOSE: To determine the feasibility and role of early scanning in the assessment of arteriovenous fistulae fashioned for vascular access. METHODS: Retrospective case note analysis of 98 patients who underwent early scanning (between 7 and 28 days) of their fistula as well as routine scanning at 6 weeks over a 2-year period. RESULTS: The median time was 16 days to the first scan and 51 days to the second scan. Only 1 fistula was unable to be assessed at the first scan. There were 73 normal first scans, 11 of these had an abnormal second scan showing 4 occlusions, 4 stenoses, and 3 with low flow. There were 25 abnormal first scans. Five were occluded with a mean time to scan of 16.7 days. Eleven of the 25 had a narrow vein. By the second scan, 6 had matured, 3 had occluded, and 2 had failed to mature. Nine of the 25 had low flow, elevated velocities, or a stenosis. By the second scan, 2 had matured, 4 had occluded, and 3 had failed to mature. CONCLUSIONS: Our results show that early scanning in the surveillance of arteriovenous fistula formation for vascular access is both feasible and reveals a significant number of abnormalities. Early scanning does not remove the need for the routine 6-week scan.
PURPOSE: To determine the feasibility and role of early scanning in the assessment of arteriovenous fistulae fashioned for vascular access. METHODS: Retrospective case note analysis of 98 patients who underwent early scanning (between 7 and 28 days) of their fistula as well as routine scanning at 6 weeks over a 2-year period. RESULTS: The median time was 16 days to the first scan and 51 days to the second scan. Only 1 fistula was unable to be assessed at the first scan. There were 73 normal first scans, 11 of these had an abnormal second scan showing 4 occlusions, 4 stenoses, and 3 with low flow. There were 25 abnormal first scans. Five were occluded with a mean time to scan of 16.7 days. Eleven of the 25 had a narrow vein. By the second scan, 6 had matured, 3 had occluded, and 2 had failed to mature. Nine of the 25 had low flow, elevated velocities, or a stenosis. By the second scan, 2 had matured, 4 had occluded, and 3 had failed to mature. CONCLUSIONS: Our results show that early scanning in the surveillance of arteriovenous fistula formation for vascular access is both feasible and reveals a significant number of abnormalities. Early scanning does not remove the need for the routine 6-week scan.
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