ROLE OF DOPPLER EVALUATION IN CREATING ARTERIOVENOUS FISTULA FOR HEMODIALYSIS – AN OBSERVATIONAL STUDY

Abstract

Introduction: The utility of Doppler ultrasound (DU) to assess the development and management of arteriovenous fistulas (AVF) for haemodialysis can help to increase the prevalence and patency of AVFs. This study aimed to plan arterio-venous access and map vessels using Doppler ultrasonography. Material and method: This was an observational study with 33 patients with chronic kidney failure suggested for AV access placement and subjects with previous AV fistula failure scheduled for reconstruction at a different site. Preferred site of access placement was planned by Duplex Doppler sonography by assessment of vessel caliber, wall morphology, peak systolic value of arteries and patency of vessels based on criteria. Venous component, Arterial component and AVF were considered as primary outcome variables. Type of anastomoses was considered as primary explanatory variable. Statistical significance was defined as a P value of less than 0.05. SPSS software; V. 22 was used to analyse the data. Results: Most of the patients involved in the study were aged between 50-59 years (42.42%) with male predominance. The most common location for AV fistula creation was in Brachio-cephalic site in 45.45% and Radio-cephalic site in 33.33% and lastly Brachial-median cubital site in 21.21% of participants. Out of 33 participants, 5 people had complications, out of which 60% of participants had CV thrombus and 40% of participants had pseudoaneurysm. 30.30% of participants showed successful maturation of AVF and 69.69% showed failure of maturation of AVF. Mean blood flow in matured AVF was > 500 ml/min (1472 ml/min) and in immature AVFs it was less than 500 ml/min (404 ml/min). xix Conclusion: All AVFs with an adequate flow volume of more than 500 ml/min, velocity, width & depth from skin were found to be related to the maturation of AVF in all types of AVF.