Arteriovenous Fistula Surveillance Using Tomographic 3D Ultrasound
| Autor: | Katie Simm, Simon Lea, Adam Haque, Ramasubramanyan Chandrasekar, Steven Rogers, Charles McCollum, Sharifah Kiyegga |
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| Rok vydání: | 2020 |
| Předmět: |
Time Factors
Arteriovenous fistula Constriction Pathologic 030204 cardiovascular system & hematology 030230 surgery Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Arteriovenous Shunt Surgical Imaging Three-Dimensional Interquartile range Renal Dialysis Medicine Humans 3D ultrasound Tomography Vascular Patency Ultrasonography Doppler Duplex medicine.diagnostic_test business.industry Limits of agreement Ultrasound Angiography Graft Occlusion Vascular Gold standard (test) medicine.disease Stenosis 3d image Regional Blood Flow Surgery Cardiology and Cardiovascular Medicine business Nuclear medicine Blood Flow Velocity |
| Zdroj: | European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. 62(1) |
| ISSN: | 1532-2165 |
| Popis: | A well functioning arteriovenous fistula (AVF) is essential for haemodialysis. Despite regular duplex ultrasound (DUS) a significant number of AVFs fail. Tomographic 3D ultrasound (tUS) creates a 3D image of the AVF that can be interpreted by the clinician. DUS, tUS, and fistulograms were compared for the identification and measurement of flow limiting stenosis.Patients with AVF dysfunction on routine Transonic surveillance, defined as (1)15% reduction in flow on two consecutive occasions, (2)30% reduction in flow on one occasion, (3) flow of600 mL/sec, (4) presence of recirculation, underwent DUS. AVF tUS imaging was performed prior to fistulography. All fistulograms were reported by the same consultant radiologist and tUS images by the same vascular scientist blinded to the fistulogram results. Maximum diameter reduction in all stenoses were measured using all three imaging techniques.In 97 patients with 101 stenoses, the mean (± standard deviation [SD]) severity of stenosis was 63.0 ± 13.9%, 65.0 ± 11.6%, and 64.8 ± 11.7% for the fistulograms, DUS, and tUS respectively. The mean (± SD) time between ultrasound and fistulography imaging was 15.0 ± 14.5 days. Assuming the fistulogram as the "gold standard", Bland-Altman agreement for DUS was -1.9 ± 15.5% (limit of agreement [LOA] -32.2 - 28.4) compared with -1.7 ± 15.4% (LOA -31.9 - 28.4) for tUS. Median (± interquartile range) time to complete the investigation was 09:00 ± 03:19 minutes for DUS and 03:13 ± 01:56 minutes for tUS (p.001).DUS and tUS were equally accurate at detecting AVF complications but tUS investigation requires less skill and was significantly quicker than DUS. |
| Databáze: | OpenAIRE |
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