Advertisement

Arteriovenous Fistulas

  • Wilhelm Schäberle
Chapter

Abstract

Of the 50,000 patients with end-stage renal failure in Germany, each year some 15,000 become candidates for creation of a hemodialysis access. A native arteriovenous (AV) fistula has a better prognosis with longer patency and fewer complications such as infections and is preferred to a synthetic graft (Tordoir et al. 2007). An advantage of a synthetic dialysis access is that it can be used earlier, while a native fistula needs time to mature before it can be used for hemodialysis. A synthetic shunt is the second option in patients whose native vein (typically the cephalic vein) is deemed unsuitable because of a small lumen or because it has undergone thrombotic or fibrotic degeneration as a result of frequent puncture. A minimum flow volume is necessary to ensure adequate dialysis treatment. Protocols in the USA require a flow volume of at least 350 mL/min, while smaller volumes of 200–300 mL/min are still considered acceptable in some European countries including Germany. This requirement informs the preoperative search for a suitable vein for creating an AV fistula and the identification of patients who need a synthetic vascular access. Preoperative vascular mapping contributes important information for selecting the most suitable hemodialysis access for each patient.

References

  1. Ahmad S, Blagg CR, Scribner BH (1998) Center and home chronic hemodialysis. In: Schrier RW, Gottschalk CW (eds) Diseases of the kidney, 4th edn, pp 3281–3322Google Scholar
  2. Anaya-Ayala JE, Pettigrew CD, Ismail N et al (2012) Management of dialysis access-associated “steal” syndrome with DRIL procedure: Challenges and clinical outcomes. J Vasc Access 13:299–304CrossRefPubMedGoogle Scholar
  3. Aschwanden M, Hess P, Labs KH et al (2003) Dialysis access-associated steal syndrome: the intraoperative use of duplex ultrasound scan. J Vasc Surg 37:211–213CrossRefPubMedGoogle Scholar
  4. Bay WH, Henry ML, Lazarus JM et al (1998) Predicting hemodialysis access failure with color flow Doppler ultrasound. Am J Nephrol 18:296–304CrossRefPubMedGoogle Scholar
  5. Brittinger WD, Twittenhoff W-D, Walker G, Konrad N (1966) Revaskularisation des Dialyseshunts. Nieren- und Hochdruckkrankheiten 25:4–9Google Scholar
  6. Clark TW, Cohen RA, Kwak A et al (2007) Salvage of nonmaturing native fistulas by using angioplasty. Radiology 242:286–292CrossRefPubMedGoogle Scholar
  7. Doelman C, Duijm LE, Liem YS et al (2005) Stenosis detection in failing hemodialysis access fistulas and grafts: comparison of color Doppler ultrasonography, contrast-enhanced magnetic resonance angiography and digital subtraction angiography. J Vasc Surg 42:739–746CrossRefPubMedGoogle Scholar
  8. Finlay DE, Longley DG, Foshager MC, Letourneau JG (1993) Duplex and color Doppler sonography of hemodialysis arteriovenous fistulas and grafts. Radiographics 13:983–989CrossRefPubMedGoogle Scholar
  9. Grogan J, Castilla M, Lozanski L et al (2005a) Frequency of critical stenosis in primary arteriovenous fistulae before hemodialysis access: should duplex ultrasound surveillance be the standard of care? J Vasc Surg 41:1000–1006CrossRefPubMedGoogle Scholar
  10. Grogan JK, Shaalan WE, Cheng H (2005b) B-mode ultrasonographic characterization of carotid atherosclerotic plaques in symptomatic and asymptomatic patients. J Vasc Surg 42:435–441CrossRefPubMedGoogle Scholar
  11. Grosser S, Kreymann G, Kühns A (1991) Duplex-sonographisch quantifiziertes Shuntvolumen und dessen klinische Relevanz. Angio Arch 22:74–77Google Scholar
  12. Haimov H, Giron F, Jacobsen JH (1979) The expanded polytetrafluoroethylene graft. Three years` experience with 362 grafts. Arch Surg 114:673–677CrossRefPubMedGoogle Scholar
  13. Harnoss B-M, Keller F, Häring R, Distler A, Maurer PC (Hrsg) (1991) Der Dialyseshunt als chirurgische und nephrologische Aufgabe. Angio Archiv 22Google Scholar
  14. Heberer G, Van Dongen RJAM (eds) (1993) Gefäßchirurgie. Springer, Berlin/Heidelberg/New York/Tokyo. Kirschnersche allgemeine und spezielle Operationslehre, Bd 11Google Scholar
  15. Hecking C, Aschwanden M, Dickenmann M et al (2006) Efficient haemodialysis despite complete central venous thrombosis. Vasa 35:243–244CrossRefPubMedGoogle Scholar
  16. Huber TS, Ozaki CK, Flynn TC et al (2002) Prospective validation of an algorithm to maximize native arteriovenous fistulae for chronic hemodialysis access. J Vasc Surg 36:452–459CrossRefPubMedGoogle Scholar
  17. Jiang S, Stewart G, Barnes E et al (2013) Effect of vascular access surveillance program on service provision and access thrombosis. Semin Dial 26:361–365CrossRefPubMedGoogle Scholar
  18. Kathrein H (1991) Duplexsonographie von Dialyseshunts. Springer, Berlin/Heidelberg/New York/TokyoCrossRefGoogle Scholar
  19. Kathrein H, König P, Dittrich P, Judmeier G (1988) Nichtinvasisve Beurteilung von Cimino-Brescia-Fisteln und PTFE-Shunts mit der Duplexsonographie. Vasa 26(Suppl):39–41PubMedGoogle Scholar
  20. Keller F, Loewe HJ, Bauknecht KJ, Schwarz A, Offermann G (1988) Kumulative Funktionsraten von orthotopen Dialysefisteln und Interponaten. Dtsch Med Wschr 113:332–336CrossRefPubMedGoogle Scholar
  21. Keller F, Harnoss B-M, Czerlinsky H (1991) Umfrageergebnisse zur Technik der Ciminofistel. Angio. Archiv 22:7–9Google Scholar
  22. Korten E, Toonder IM, Schrama YC et al (2007) Dialysis fistulae patency and preoperative diameter ultrasound measurement. Eur J Vasc Endovasc Surg 33:467–471CrossRefPubMedGoogle Scholar
  23. Lockhart ME, Robbin ML (2001) Hemodialysis access ultrasound. Ultrasound Q 17:157–167CrossRefPubMedGoogle Scholar
  24. Lockhart ME, Robbin MI, Allon M (2004) Preoperative sonographic radial artery evaluation and correlation with subsequent radiocephalic fistula outcome. J Ultrasound Med 23:161–168CrossRefPubMedGoogle Scholar
  25. Mendes RR, Farber MA, Marston WA et al (2002) Prediction of wrist arteriovenous fistula maturation with preoperative vein mapping with ultrasonography. J Vasc Surg 36:460–463CrossRefPubMedGoogle Scholar
  26. Mickley V (2006) Central vein obstruction in vascular access. Eur J Vasc Endovasc Surg 32:439–444CrossRefPubMedGoogle Scholar
  27. Munda R, First MR, Alexander JW, Linnemann CC, Fidler JP, Kittur D (1983) Polytetrafluoroethylene graft survival in hemodialysis. J Am Med Assoc 249:219–222CrossRefGoogle Scholar
  28. National Kidney Foundation (2006) KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for 2006 Updates: Hemodialysis Adequacy, Peritoneal Dialysis Adequacy and Vascular Access. Am J Kidney Dis 48(suppl 1):S1–S322Google Scholar
  29. Neville RF, Abularrage CJ, White PW et al (2004) Venous hypertension associated with arteriovenous hemodialysis access. Semin Vasc Surg 17:50–56CrossRefPubMedGoogle Scholar
  30. Older RA, Gizienski TA, Wilkowski MJ et al (1998) Hemodialysis access stenosis: early detection with color Doppler US. Radiology 207:161–164CrossRefPubMedGoogle Scholar
  31. Parmar J, Aslam M, Standfield N (2007) Pre-operative radial arterial diameter predicts early failure of arteriovenous fistula (AVF) for haemodialysis. Eur J Vasc Endovasc Surg 33:113–115CrossRefPubMedGoogle Scholar
  32. Paulson WD, Moist L, Lok CE (2013) Vascular access surveillance: Case study of a false paradigm. Semin Dial 26:281–286CrossRefPubMedGoogle Scholar
  33. Pietura R, Janczarek M, Zaluska W et al (2005) Colour Doppler ultrasound assessment of well-functioning mature arteriovenous fistulas for haemodialysis access. Eur J Radiol 55:113–119CrossRefPubMedGoogle Scholar
  34. Planken RN, Keuter XH, Kessels AG et al (2006) Forearm cephalic vein cross-sectional area changes at incremental congestion pressures: towards a standardized and reproducible vein mapping protocol. J Vasc Surg 44:353–358CrossRefPubMedGoogle Scholar
  35. Robbin ML, Oser RF, Allon M et al (1998) Hemodialysis access graft stenosis: US detection. Radiology 208:655–661CrossRefPubMedGoogle Scholar
  36. Robbin ML, Chamberlain NE, Lockhart ME et al (2002) Hemodialysis arteriovenous fistula maturity: US evaluation. Radiology 225:59–64CrossRefPubMedGoogle Scholar
  37. Rooijens PP, TordoirJH ST et al (2004) Radiocephalic wrist arteriovenous fistula for hemodialysis: meta-analysis indicates a high primary failure rate. Eur J Vasc Endovasc Surg 28:583–589CrossRefPubMedGoogle Scholar
  38. Roy-Chaudhury P, Kelly BS, Miller MA et al (2001) Venous neointimal hyperplasia in polytetraflouroethylene dialysis grafts. Kidney Int 59:2325–2334CrossRefPubMedGoogle Scholar
  39. Scali ST, Chang CK, Raghinaru D et al (2013) Prediction of graft patency and mortality after distal revascularization and interval ligation for hemodialysis access-related hand ischemia. J Vasc Surg 57:451–458CrossRefPubMedGoogle Scholar
  40. Schäberle W, Leyerer L (2014) Structured, time-efficient and therapy-oriented ultrasonography diagnostics for dialysis shunt problems. Gefässchirurgie 19:471–480CrossRefGoogle Scholar
  41. Scholz H (1998) Der adäquate Gefäßzugang für die Hämodialyse. Bard, Impra, MünchenGoogle Scholar
  42. Silva MB Jr, Hobson RW, Pappas PJ et al (1998) A strategy for increasing use of autogenous hemodialysis access procedures: impact of preoperative noninvasive evaluation. J Vasc Surg 27:302–307CrossRefPubMedGoogle Scholar
  43. Tellis VA, Kohlberg WI, Bhat DJ, Driscoll B, Veith FJ (1979) Expanded polytetrafluoroethylene graft fistula for chronic hemodialysis. Ann Surg 189:101–105CrossRefPubMedPubMedCentralGoogle Scholar
  44. Tonelli M, James M, Wiebe N et al (2008) Ultrasound monitoring to detect access stenosis in hemodialysis patients: a systematic review. Am J Kidney Dis 61:630–640CrossRefGoogle Scholar
  45. Tordoir JHM, De Bruin HG, Hoeneveld H, Eikelboom BC, Kitslaar PJ (1989) Duplex ultrasound scanning in the assessment of arteriovenous fistulas created for hemodialysis access: comparison with digital subtraction angiography. J Vasc Surg 10:122–128CrossRefPubMedGoogle Scholar
  46. Tordoir J, Canaud B, Haage P et al (2007) EBPG on vascular access. Nephrol Dial Transplant 22:ii88–ii117CrossRefPubMedGoogle Scholar
  47. Turmel-Rodrigues L, Pengloan J, Baudin S et al (2000) Treatment of stenosis and thrombosis in haemodialysis fistulas and grafts by interventional radiology. Nephrol Dial Transplant 15:2029–2036CrossRefPubMedGoogle Scholar
  48. Vachharajani TJ (2012) Diagnosis of arteriovenous fistula dysfunction. Semin Dial 25:445–450CrossRefPubMedGoogle Scholar
  49. Zanow J, Petzold K, Petzold M et al (2006) Flow reduction in high-flow arteriovenous access using intraoperative flow monitoring. J Vasc Surg 44:1273–1278CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Wilhelm Schäberle
    • 1
  1. 1.Department of Visceral, Vascular, Thoracic, and Pediatric SurgeryAlb Fils KlinikenGöppingenGermany

Personalised recommendations