| Title: | Doppler ultrasound assessment of calcified radial arteries prior to radio-cephalic arterio-venous fistula placement : an observational study |
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| Authors: | ID Gubenšek, Jakob (Author) |
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| Files: |  PDF - Presentation file, download (1,09 MB)
MD5: 599A3572AED3A887883F09EBEE4DC0DF
 URL - Source URL, visit https://journals.sagepub.com/doi/10.1177/11297298221143598
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| Language: | English |
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| Typology: | 1.01 - Original Scientific Article |
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| Organization: |  UKC LJ - Ljubljana University Medical Centre
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| Abstract: | Background: In elderly and diabetic patients, arterial calcifications are prevalent and result in worse outcomes of arterio-venous fistulas (AVFs). Optimal ultrasound criteria for assessment of calcified arteries are unknown. We report our experience with ultrasound assessment of calcified arteries prior to placement of radio-cephalic (RC) AVFs. Material and methods: We included 85 patients in whom a RC-AVF placement was planned. Patients were divided according to the presence of radial artery calcifications into a calcified group (moderate/severe calcifications, N = 18) and control group (no changes/mild atherosclerosis, N = 67). Doppler ultrasound parameters were analyzed in the calcified group with focus on assessment of the artery, including grading of calcifications and Doppler measurements at rest and during reactive hyperemia (RH). Results: In the calcified group mean patients’ age was 72 ± 11 years, 72% were diabetics, mean resistance index (RI) during RH was 0.78 ± 0.09 (range 0.63–0.90). In 14 (78%) patients an AVF was successfully placed and in 12 it matured (67% maturation rate). A lower RI at rest was observed in the primary failure sub-group with high area under the ROC curve (0.89) and a cut-off value of 0.90 for RI. There was no difference in RI at RH between failed and matured AVFs. 1-year secondary patency was 66% and in eight patients with follow-up ultrasound available, blood flow was 350–1300 ml/min. For comparison, in the control group a radio-cephalic AVF was placed in all patients, primary failure rate was 6%, maturation rate 85% and 1-year secondary patency was 77%. Conclusions: Our very limited experience suggests that successful RC-AVF placement and maturation with good 1-year patency rates is possible in patients with moderately/severely calcified arteries and RI during RH of up to 0.90. |
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| Keywords: | vascular mapping, arterial calcifications, arterio-venous fistula, outcomes, hemodialysis |
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| Publication status: | Published |
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| Publication version: | Version of Record |
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| Year of publishing: | 2024 |
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| Number of pages: | str. 897-903 |
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| Numbering: | Vol. 25, iss. 3 |
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| PID: | 20.500.12556/DiRROS-30037  |
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| UDC: | 616.6 |
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| ISSN on article: | 1129-7298 |
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| DOI: | 10.1177/11297298221143598 |
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| COBISS.SI-ID: | 137222403 |
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| Publication date in DiRROS: | 12.06.2026 |
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| Views: | 21 |
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| Downloads: | 16 |
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