Approach to an Arteriovenous Access with Hyperpulsatile Pulse
A hyperpulsatile arteriovenous fistula (AVF) indicates a dialysis vascular access with a significant stenosis in the outflow segment. The physical examination performed with a hyperpulsatile AVF includes the arm elevation test, assessment of thrill in the segment distal to the stenosis, and listening to the pitch of the bruit over the entire outflow segment. A clinical finding of prolonged bleeding post withdrawal of dialysis needles is commonly encountered with hyperpulsatile AVF. The algorithm used in clinical practice for the appropriate management and role of percutaneous endovascular therapy for outflow stenosis is discussed in this chapter.
- 3.Fistula First Breakthrough Initiative www.fistulafirst.org/HealthcareProfessionals/FFBIChangeConcepts/ChangeConcept9.aspx; 2013. Accessed on 26 Oct 2013.