Colour Doppler ultrasound assessment of arteriovenous haemodialysis fistulas.

Abstract

Satisfactory function of the arteriovenous fistula (AVF) is essential for adequate haemodialysis in patients with chronic renal failure. Existing methods to assess AVF function are imprecise (eg, clinical examination) or invasive (eg, angiography). We assessed the value of colour flow-doppler ultrasound (CFDU) in the investigation of clinically suspected AVF dysfunction. 51 patients with suspected impairment of AVF function were studied by CFDU, and 28 also underwent angiography. The findings were compared with the reference standard of the findings at reoperation. CFDU showed AVF stenoses in 18 patients, which were all confirmed at reoperation; the results of angiography in 13 of these 18 patients showed complete agreement with the findings of CFDU and surgery. CFDU showed partial or complete AVF thrombosis in 33 patients, confirmed in all patients at reoperation; 15 patients also underwent angiography, and thrombi were not found in 6 (in 4 because of technical failure). 7 patients had aneurysms on CFDU that were confirmed by surgery in all patients and by angiography in 2 of the 3 patients studied. CFDU enables reliable non-invasive assessment of AVF morphology and function and may become the procedure of choice for AVF assessment in patients with suspected AVF abnormalities.