Diagnostic value of color Doppler ultrasonography and MultiDetector Computer Tomography (MDCT) angiography in complications of hemodialysis fistulas

Abstract

Background: With increasing number of patients who suffered from end-stage renal disease and under long-term hemodialysis, the functioning vascular access means better prognosis and quality of life for these patients is essential. Nowadays the autologuous arteriovenous fistula (AVF) and the synthetic arteriovenous graft (AVG) remain the major access alternatives of choice, which have the advantage of long-term survival. Aims: To evaluate the role and usefulness of Multidetector CT angiography (CTA) and color Doppler US (CDUS) in assessment of vascular tree of AVFs and comprehensive evaluation of possible shunt complications in ESRD patients on hemodialysis. Methodology: End-stage renal disease for which long-term hemodialysis is required for a significant percentage of the population. The arteriovenous fistula has become the most widely used mean of providing vascular access for patients on regular hemodialysis. Conclusion: the obtained results document that Color Doppler US is readily available, noninvasive method, inexpensive, and has no radiation exposure or use of contrast material. It allows assessment of both anatomy and hemodynamics of an AVF. However the quality of images depends on the skill of the operator. Other drawbacks of color Doppler US are the inaccurate detection of central venous obstruction and the absence of an angiographic map, which may be desired for surgery. Keywords: color Doppler US, Multidetector CT, AVFs, ESRD patients, hemodialysis.