Value of color Doppler sonography in the assessment of hemodialysis access dysfunction

Abstract

Arteriovenous fistula (AVF) is the most widely used means of vascular access for long-term hemodialysis (HD) and the complication rate related to AVF remains high. This study was conducted to determine the efficiency of Color Doppler sonography (CDS) in the assessment of AVF dysfunction. Over a period of 29 months, from January 2005 to May 2007, a total of 55 patients with AVF access dysfunction were included in the study. CDS were performed in the King Fahd Hospital of the University, Al-Khobar, Saudi Arabia. CDS allowed identification of 23 patients with stenotic segments and 16 others with venous thromboses. Six patients with venous aneurysm were encountered. Doppler flow rate assessment allowed differentiation of venous hypertension in two patients and steal syndrome in two other patients. Thus, the CDS findings carried a sensitivity rate of 96.4%. Two subclavian vein stenoses, causing reduced blood flow rate, were missed by CDS and later confirmed by angiography. Thirty-four patients underwent operative intervention. Our study suggests that CDS is an ideal noninvasive technique that allows the assessment of both anatomy and hemodynamics of an AVF.