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| Journal of Vascular Access 2008; 9: 1 - 9 |
| Duplex ultrasound evaluation for dialysis access selection and maintenance: a practical guide |
I.J. Davidson1, D. Chan 2, B. Dolmatch2, M. Hasan3, D. Nichols4, R. Saxena5, S. Shenoy6, M. Vazquez5, M. Gallieni7
1Division of Transplant, Department of Surgery, Parkland Memorial Hospital University of Texas Southwestern Medical Center, Dallas - USA
2Division of Interventional Radiology, University of Texas Southwestern Medical Center, Dallas - USA
3Baptist Cardiac & Vascular Institute, Miami, Florida - USA
4Vascular Center, Medical City Hospital Dallas - USA
5Division of Nephrology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas - USA
6Section of Transplantation, Department of Surgery, Washington University School of Medicine, St Louis - USA
7Renal Unit, San Paolo Hospital, University of Milano, Milano - Italy
ABSTRACT
Detailed case directed history and examination is the mainstay of dialysis access modality selection, ie site and type of access, as well as for maintenance of dialysis access for longevity. As a logical step following history and physical examination, duplex ultrasound evaluation (DUE) is the most cost effective and non-invasive screening tool for evaluation for access placement and for assessment of an established access. Pre-operative vascular mapping allows selection of the optimal dialysis access modality and site. In established accesses, duplex ultrasound testing will diagnose the majority of vascular access complications and direct proper surgical or interventional radiology management. This review outlines a practical decision-making algorithm using DUE for choosing and managing the dialysis access.
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