Use of early scanning in fistula formation for vascular access

J Vasc Access. Apr-Jun 2011;12(2):127-9. doi: 10.5301/jva.2010.6072.

Abstract

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.

MeSH terms

  • Arteries / diagnostic imaging*
  • Arteries / surgery
  • Arteriovenous Shunt, Surgical / methods*
  • Catheters, Indwelling
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Retrospective Studies
  • Ultrasonography, Doppler, Duplex / methods*
  • Veins / diagnostic imaging*
  • Veins / surgery