The importance of ultrasonography in surgical treatment of vascular access for hemodialysis complications

Abstract

Background. Most complications of vascular access for hemodialysis require surgical treatment and if ineffective lead to fistula loss and depletion of the vascular resource for the new fistula creation.Objective. To identify complications of permanent vascular access for hemodialysis which require surgical treatment and evaluate its results using duplex scanning.Design and methods. Ultrasonography, clinical and laboratory examinations were performed in 550 patients undergoing hemodialysis.Results. Complications of vascular access for hemodialysis were detected in 154 (28.0 %) patients, surgical treatment was performed in 96 (62.3 %) patients. The main indications for surgical treatment were: significant stenosis, occlusive thrombosis, non-occlusive thrombosis in combination with significant vein stenosis, aneurysm with increased access flow, ischemic steal syndrome of the hand and pulsating hematoma. The analysis of surgical interventions showed that the creation of a new access was more often performed (41.7 %) compared to other types of fistula reconstructions which leads to a decrease in the number of vessels in the upper extremities that can be used to create access in the future.Conclusion. Duplex ultrasound allows diagnosing vascular access for hemodialysis complications and evaluating the results of their surgical treatment.