Accuracy of early postoperative clinical and ultrasound examination of arteriovenous fistulae to predict dialysis use.
J Vasc Access
; 15(4): 291-7, 2014.
Article
em En
| MEDLINE
| ID: mdl-24500848
ABSTRACT
AIM:
The aim of this article is to assess the accuracy of early clinical and ultrasound (US) examination in terms of predicting arteriovenous fistula (AVF) dialysis use.METHODS:
Physical and US examination of patent AVF was performed 4 weeks after fistula creation. AVF dialysis use was defined as subsequent use of an AVF for at least six consecutive dialysis sessions with two needles and a blood flow of more than 200 mL/min.RESULTS:
Of 119 AVF patent at 4 weeks, 26 (22%) failed. Clinical examination was 96% sensitive for predicting successful dialysis, but only 21% specific for failure. Vein diameter above 5 mm and an arterial end-diastolic velocity above 110 cm/s were the best US predictors for dialysis use. Vein diameter was slightly better than arterial velocity in terms of predicting maturity (sensitivity 83% vs 67%, specificity 68% vs 65%). All assessments predicted AVF maturity (positive predictive value clinical = 81%, US diameter = 90%, US velocity = 87%) much better than AVF failure (negative predictive value clinical = 63%, US diameter = 53%, US velocity = 37%).CONCLUSION:
One month after surgery, a new AVF with a thrill or a vein diameter >5 mm is likely to be used for dialysis. An AVF not meeting these criteria has an increased risk of failure and further investigations may be required.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Derivação Arteriovenosa Cirúrgica
/
Diálise Renal
/
Ultrassonografia de Intervenção
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Extremidade Superior
Tipo de estudo:
Clinical_trials
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
J Vasc Access
Assunto da revista:
ANGIOLOGIA
Ano de publicação:
2014
Tipo de documento:
Article