The Value of Ultrasound Evaluation and Marking before Arteriovenous Internal Fistula in Uremia Patients_West China Medical Journal

Authors：

 LIUChun-cheng ¹ , SHIYing-yu ¹ , CUITian-lei ² , LUOYan ¹ , PENGYu-lan ¹ ,  WENXiao-rong ¹

1. Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

WENXiao-rong, Email: hxwenxiaor@126.com

Keywords：

Uremia; Arteriovenous internal fistula; Color Doppler ultrasound; Assessment; Marking

DOI：

10.7507/1002-0179.20140216

Video：

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Objective To explore the value of ultrasound evaluation and marking before arteriovenous internal fistula in end-stage renal disease hemodialysis patients. Methods Twenty-five uremia end-stage patients were admitted into our nephrology department from January 2012 to July 2012. All of the patients had encountered several times of fistula failure or had difficulty in establishing the forearm arteriovenous fistula. We focused on observing the brachial artery, radial artery, cephalic vein, the basilica vein and great saphenous vein. We measured the diameter of the vessels and marked the trend of arteries and veins in the body surface under the ultrasonic navigation. Our goal was to look for appropriate bypass vessels in the elbow and the upper arm. Results Fourteen patients had endured several times of fistula failure. Among the 14 patients, 9 patients completed the surgery of reengineering fistula and autogenous great saphenous vein transplantation, 2 accepted artificial vascular transplantation, 1 completed the removal of blood clots in the left upper limb artificial blood vessels and arteriovenous internal fistula molding, and 2 gave up surgery. Eleven patients could not complete the arteriovenous fistula operation for the fine forearm superficial vein. Of them, 2 patients accepted artificial vascular operation, 6 underwent autogenous great saphenous vein transplantation, 1 with slender radial artery in diameter completed higher position fistula between the brachial artery and median cubital vein, and 2 gave up surgery. Conclusion Arteriovenous internal fistula preoperative ultrasound assessment and marking have very important value in improving the success rate of operation in end-stage uremia patients.

Citation： LIUChun-cheng, SHIYing-yu, CUITian-lei, LUOYan, PENGYu-lan, WENXiao-rong. The Value of Ultrasound Evaluation and Marking before Arteriovenous Internal Fistula in Uremia Patients. West China Medical Journal, 2014, 29(4): 725-727. doi: 10.7507/1002-0179.20140216 Copy

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1. Konner K. Vascular access for dialysis in diabetic patients[J]. Edtna Erca J, 2005, 30(3):148-150.
2. Konner K, Nonnast-Daniel B, Ritz E. The arteriovenous fistula[J]. J Am Soc Nephrol, 2003, 14(6):1669-1680.
3. Robbin ML, Oser RF, Lee JY, et al. Randomized comparison of ultrasound surveillance and clinical monitoring on arteriovenous graft outcomes[J]. Kidney Int, 2006, 69(4):730-735.
4. 李晨, 张红, 杨德民, 等. 高频彩超在尿毒症患者动静脉内瘘术前的应用[J]. 中国血液净化, 2008, 7(7):363-365.
5. 李盛, 尚继先. 桡动脉头静脉吻合内瘘失败原因分析[J]. 山西医药杂志, 2004, 33(7):614-615.
6. 唐杰, 温朝阳. 腹部和外周血管彩色多普勒诊断学[M]. 3版. 北京:人民卫生出版社, 2007:285.
7. Bhandari S, Wilkinson A, Sellars L. Saphenous vein forearm grafts and gortex thigh grafts as alternative forms of vascular access[J]. Clin Nephrol, 1995, 44(5):325-328.
8. Oto T. Endoscopic saphenous vein harvesting for hemodialysis vascular access creation in the forearm:a new approach for arteriovenous bridge graft[J]. J Vasc Access, 2007, 4(3):98-101.
9. 叶建荣, 冯友贤. 自体大隐静脉移植在血管外科的应用[J]. 国外医学·创伤与外科基本问题分册, 1985, 1(1):5-8.
10. 张信英, 邵振恒, 于钟毓, 等. 血管移植治疗四肢动脉损伤用[J]. 中华显微外科杂志, 1991, 14(2):104-106.
11. 叶朝阳. 血管通路的功能评估[J]. 中国血液净化, 2007, 6(7):361-364.
12. 郑露, 张磊, 戎殳, 等. 老年自体动静脉内瘘在血液透析中的应用[J]. 中国血液净化, 2004, 3(12):649-651.
13. Zwiebel WJ, Pellerito JS. 血管超声经典教程[M]. 温朝阳, 译.北京:人民军医出版社, 2008:195.

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West China Medical Journal

The Value of Ultrasound Evaluation and Marking before Arteriovenous Internal Fistula in Uremia Patients

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