20.500.12556/DiRROS-28786 Detailed ultrasonographic assessment of calcified arteries before arterio-venous fistula construction and fistula outcomes a prospective observational study Background Arterial calcifications (mainly mediocalcinosis) are highly prevalent in patients on hemodialysis. Severe calcifications reduce the possibility of a forearm arterio-venous fistula (AVF) construction, reduce maturation rates and increase the risk of hemodialysis access-induced distal ischemia (HAIDI). We report a prospective observational study on detailed ultrasound assessment of calcified arteries and outcomes of AVFs constructed in those conditions. Methods In patients referred for vascular mapping, distal, mid and proximal radial artery (RA) as well as brachial artery were assessed for grade of calcifications (B-mode), homogeneity of color Doppler (CD) and compressibility of the artery. Pulsed-wave Doppler parameters at rest and during reactive hyperemia were also assessed. Based on the results, a site for AVF construction was planned. Outcomes of constructed AVFs were assessed. Results In 35 patients (mean age 68±13 years, 89% diabetics) we assessed 240 arterial sites, made 44 plans and constructed 31 AVFs/grafts. We observed several ultrasonographic phenotypes of calcified arteries. Severely calcified arteries (B-mode assessment) were heterogeneous when assessed for CD homogeneity and compressibility. Constructed AVFs/grafts had very good maturation rates (> 75%) even in a subgroup of radio-cephalic AVFs made on significantly calcified RAs (79%). There were no cases of clinically significant HAIDI. Conclusions AVF construction with high likelihood of maturation and low likelihood of HAIDI in patients with significantly calcified arteries is possible, after proper evaluation of the artery. Homogeneity of CD and compressibility of the artery with ultrasound probe are useful additional criteria for assessing the suitability of a severely calcified artery for AVF construction. arterial calcifications maturation rate reactive hyperemia ultrasound assessment vascular access arterijska kalcifikacija hitrost zorenja reaktivna hipermija ultrazvočna ocena žilni dostop true false true Angleški jezik Slovenski jezik Neznano 2026-04-07 13:35:45 2026-04-07 13:35:46 2026-04-08 03:47:41 0000-00-00 00:00:00 2026 0 0 Nasl. z nasl. zaslona; Opis vira z dne 31. 12. 2025; str. 1-11 iss. 1, [Article no.] 2 Vol. 27 Jan. 2026 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.1 1471-2369 10.1186/s12882-025-04660-9 263259651 RAZ_Gubensek_Jakob_2026.pdf RAZ_Gubensek_Jakob_2026.pdf 1 063AF20DBAEA85D72596234DBD340577 43f5728da32c7439b7b90637f40ab3b3e3d37d6b25cda0e62bc3b8a4ff08dd6f 08d58dd2-3276-11f1-b7aa-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=42867 https://link.springer.com/article/10.1186/s12882-025-04660-9 1 eca906cc-3275-11f1-b7aa-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=42866 Univerzitetni klinični center Ljubljana 0 0 0