Romero-Espinosa L, Serrano-Lozano JA, Sánchez-Nicolat NE, Loera-Barragán A, Lozano-Corona R

Language: Spanish
References: 9
Page: 50-56
PDF size: 173.44 Kb.

ABSTRACT

Objective. Determine what are the most frequent complications at the patients with end stage renal disease who have autogenous arteriovenous fistula in the Hemodialysis Service of Hospital Regional “Lic. Adolfo López Mateos”, through the ultrasound evaluation.
Background. The 25% of the hospitalizations in the hemodialysis population, has been attributed to complications of de vascular access, including dysfunction and thrombosis. The Doppler ultrasound is a very useful diagnostic tool for the preoperative evaluation, surveillance and detection of complications at the patients with arteriovenous fistulas.
Material and methods. This transversal, observational, prospective, clinical study included patients with arteriovenous fistulas who have one or more signs of dysfunction. Through Doppler ultrasound we collected representative images on specific areas of the arm. Internal arteriovenous fistulas that have ultrasonographic criteria were evaluated for detection of complications.
Results. A total of 26 cases were detected, and we found significative stenosis › 50% in 7.6% (2) and no significative stenosis ‹ 50% in 34.6% (9) of the patients. The 57.6% had aneurysmal degeneration and just one patient (3.8%) had clinical and ultrasonographic criteria for pseudoaneurysm (type 4 of Valenti's classification). The 11.5% was detected with perivascular collections. One patient (3.8%) had steal syndrome grade 1, presenting bidirectional flow in the distal inflow through the Doppler ultrasound. One patient had thrombosis and lost of the vascular access (3.8%).
Conclusions. Three types of complications were detected and evaluated through ultrasound at fistulas with dysfunction signs in all the patients of our Hemodyalisis Service. The most common was aneurysmal degeneration, followed by no signficative stenosis and perivascular collections.

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