Spiral laminar flow, the earliest predictor for maturation of arteriovenous fistula for hemodialysis access
Introduction: Arteriovenous fistula (AVF) is the gold standard vascular access for hemodialysis (HD). A thrill or murmur immediately after creation of AVF is considered a predictive sign of success. However, this does not ensure final maturation for successful HD. Our objective was to determine diff...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2015-01-01
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| Series: | Indian Journal of Urology |
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| Online Access: | http://www.indianjurol.com/article.asp?issn=0970-1591;year=2015;volume=31;issue=3;spage=240;epage=244;aulast=Srivastava |
| _version_ | 1818611476043137024 |
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| author | Aneesh Srivastava Varun Mittal Hira Lal Tarun Javali Nitesh Patidar Sanjoy Sureka Shikhar Aggarwal |
| author_facet | Aneesh Srivastava Varun Mittal Hira Lal Tarun Javali Nitesh Patidar Sanjoy Sureka Shikhar Aggarwal |
| author_sort | Aneesh Srivastava |
| collection | DOAJ |
| description | Introduction: Arteriovenous fistula (AVF) is the gold standard vascular access for hemodialysis (HD). A thrill or murmur immediately after creation of AVF is considered a predictive sign of success. However, this does not ensure final maturation for successful HD. Our objective was to determine different clinical and duplex parameters within AVF to predict maturation and subsequent successful HD.
Materials and Methods: A prospective observational study was conducted on 187 patients who had AVF formation from July 2012 to May 2013. Following surgery, all patients had Doppler ultrasound (DU) on Days 0 and 7. Doppler parameters noted in the outflow vein were: Thrill, broadening of spectral waveform with increased peak systolic velocity (PSV) and spiral laminar flow (SLF). Patients with at least one positive parameter at Day 0 were followed-up serially and underwent repeat Doppler imaging on Day 7. Patients with the absence of all three parameters on Day 0 were excluded from the study. Endpoint was maturation of AVF, i.e. successful HD. Statistical analysis was performed with binary logistic regression, to find out the strongest and earliest predictor for maturation of AVF using SPSS version 20.
Results: SLF and broadening of spectral waveform with increased PSV were found to have a significant association with maturation (P = 0.0001). Presence of SLF on Day 0 most strongly predicted maturation. Presence of thrill or murmur could not predict the maturation.
Conclusions: SLF pattern in AVF is the most important and the earliest predictor of maturation. |
| first_indexed | 2024-12-16T15:30:56Z |
| format | Article |
| id | doaj.art-529605e554154e4896fe1fdc5a1dd5a4 |
| institution | Directory Open Access Journal |
| issn | 0970-1591 1998-3824 |
| language | English |
| last_indexed | 2024-12-16T15:30:56Z |
| publishDate | 2015-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Urology |
| spelling | doaj.art-529605e554154e4896fe1fdc5a1dd5a42022-12-21T22:26:20ZengWolters Kluwer Medknow PublicationsIndian Journal of Urology0970-15911998-38242015-01-0131324024410.4103/0970-1591.159650Spiral laminar flow, the earliest predictor for maturation of arteriovenous fistula for hemodialysis accessAneesh SrivastavaVarun MittalHira LalTarun JavaliNitesh PatidarSanjoy SurekaShikhar AggarwalIntroduction: Arteriovenous fistula (AVF) is the gold standard vascular access for hemodialysis (HD). A thrill or murmur immediately after creation of AVF is considered a predictive sign of success. However, this does not ensure final maturation for successful HD. Our objective was to determine different clinical and duplex parameters within AVF to predict maturation and subsequent successful HD. Materials and Methods: A prospective observational study was conducted on 187 patients who had AVF formation from July 2012 to May 2013. Following surgery, all patients had Doppler ultrasound (DU) on Days 0 and 7. Doppler parameters noted in the outflow vein were: Thrill, broadening of spectral waveform with increased peak systolic velocity (PSV) and spiral laminar flow (SLF). Patients with at least one positive parameter at Day 0 were followed-up serially and underwent repeat Doppler imaging on Day 7. Patients with the absence of all three parameters on Day 0 were excluded from the study. Endpoint was maturation of AVF, i.e. successful HD. Statistical analysis was performed with binary logistic regression, to find out the strongest and earliest predictor for maturation of AVF using SPSS version 20. Results: SLF and broadening of spectral waveform with increased PSV were found to have a significant association with maturation (P = 0.0001). Presence of SLF on Day 0 most strongly predicted maturation. Presence of thrill or murmur could not predict the maturation. Conclusions: SLF pattern in AVF is the most important and the earliest predictor of maturation.http://www.indianjurol.com/article.asp?issn=0970-1591;year=2015;volume=31;issue=3;spage=240;epage=244;aulast=SrivastavaDopplerfistulaflow patternshemodialysispredictorspiral laminar |
| spellingShingle | Aneesh Srivastava Varun Mittal Hira Lal Tarun Javali Nitesh Patidar Sanjoy Sureka Shikhar Aggarwal Spiral laminar flow, the earliest predictor for maturation of arteriovenous fistula for hemodialysis access Indian Journal of Urology Doppler fistula flow patterns hemodialysis predictor spiral laminar |
| title | Spiral laminar flow, the earliest predictor for maturation of arteriovenous fistula for hemodialysis access |
| title_full | Spiral laminar flow, the earliest predictor for maturation of arteriovenous fistula for hemodialysis access |
| title_fullStr | Spiral laminar flow, the earliest predictor for maturation of arteriovenous fistula for hemodialysis access |
| title_full_unstemmed | Spiral laminar flow, the earliest predictor for maturation of arteriovenous fistula for hemodialysis access |
| title_short | Spiral laminar flow, the earliest predictor for maturation of arteriovenous fistula for hemodialysis access |
| title_sort | spiral laminar flow the earliest predictor for maturation of arteriovenous fistula for hemodialysis access |
| topic | Doppler fistula flow patterns hemodialysis predictor spiral laminar |
| url | http://www.indianjurol.com/article.asp?issn=0970-1591;year=2015;volume=31;issue=3;spage=240;epage=244;aulast=Srivastava |
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