DOI: 10.36347/sjams.2014.v02i03.013

Pages: 949-955

This prospective hospital based study was undertaken to reckon the value of ultrasound in preoperative vascular mapping for AVF placement and in postoperative follow-up to evaluate its maturity and complications. 100 CRF patients who needed hemodialysis access underwent preoperative US vascular mapping and among them 62 patients, who were candidates for native fistulas were reviewed on 7th and 28th postoperative days. The results were analyzed and means were calculated using Epi-InfoVer7. The mean diameters of the radial and brachial arteries were 2.37mm and 3.13mm respectively. The mean venous diameters for forearm and arm fistulas were 2.69mm and 3.18mm respectively. There was a significant increase in native AVF creation when PE was combined with US(62%) as compared to PE alone(19%). Vascular anatomy as defined by sonography, matched the operative findings in all but one (98.39% accuracy). The mean diameter of the venous limb and its flow volume of radio-cephalic and brachiocephalic/basillic fistulas at 28 day were 3.97mm & 404 ml/min and 4.52mm & 470 ml/min respectively. 67.7% of fistulas were mature at 4 weeks. In conclusion, pre-operative ultrasonographic vascular mapping is valuable in selecting potential sites for vascular access, helping in maximizing the native AVFs and decreasing the negative surgical exploration rates. Post operative follow up is of value when the status of fistula maturity is in doubt and when complications are clinically suspected.