The Role of Ultrasound Examination in the Assessment of Suitability of Calcified Arteries for Vascular Access Creation—Mini Review
Arterial calcifications are present in 20–40% of patients with end-stage kidney disease and are more frequent among the elderly and diabetics. They reduce the possibility of arterio-venous fistula (AVF) formation and maturation and increase the likelihood of complications, especially distal ischemia...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-08-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/16/2660 |
| _version_ | 1797585044434321408 |
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| author | Jakob Gubensek |
| author_facet | Jakob Gubensek |
| author_sort | Jakob Gubensek |
| collection | DOAJ |
| description | Arterial calcifications are present in 20–40% of patients with end-stage kidney disease and are more frequent among the elderly and diabetics. They reduce the possibility of arterio-venous fistula (AVF) formation and maturation and increase the likelihood of complications, especially distal ischemia. This review focuses on methods for detecting arterial calcifications and assessing the suitability of calcified arteries for providing inflow before the construction of an AVF. The importance of a clinical examination is stressed. A grading system is proposed for quantifying the severity of calcifications in the arteries of the arm with B-mode and Doppler ultrasound exams. Functional tests to assess the suitability of the artery to provide adequate inflow to the AVF are discussed, including Doppler indices (peak systolic velocity and resistive index during reactive hyperemia). Possible predictors of the development of distal ischemia are discussed (finger pressure, digital brachial index, acceleration and acceleration time), as well as the outcomes of AVFs placed on calcified arteries. It is concluded that a noninvasive ultrasound examination is probably the best tool for a morphologic and functional assessment of the arteries. An arterial assessment is of utmost importance if we are to create distal radiocephalic AVFs in our elderly patients whenever possible without burdening them with futile surgical attempts. |
| first_indexed | 2024-03-11T00:00:12Z |
| format | Article |
| id | doaj.art-60211f0c95f34c39bafae0dcb4bf71c2 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T00:00:12Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-60211f0c95f34c39bafae0dcb4bf71c22023-11-19T00:48:18ZengMDPI AGDiagnostics2075-44182023-08-011316266010.3390/diagnostics13162660The Role of Ultrasound Examination in the Assessment of Suitability of Calcified Arteries for Vascular Access Creation—Mini ReviewJakob Gubensek0Center for Acute and Complicated Dialysis and Vascular Access, Department of Nephrology, University Medical Center Ljubljana, 1000 Ljubljana, SloveniaArterial calcifications are present in 20–40% of patients with end-stage kidney disease and are more frequent among the elderly and diabetics. They reduce the possibility of arterio-venous fistula (AVF) formation and maturation and increase the likelihood of complications, especially distal ischemia. This review focuses on methods for detecting arterial calcifications and assessing the suitability of calcified arteries for providing inflow before the construction of an AVF. The importance of a clinical examination is stressed. A grading system is proposed for quantifying the severity of calcifications in the arteries of the arm with B-mode and Doppler ultrasound exams. Functional tests to assess the suitability of the artery to provide adequate inflow to the AVF are discussed, including Doppler indices (peak systolic velocity and resistive index during reactive hyperemia). Possible predictors of the development of distal ischemia are discussed (finger pressure, digital brachial index, acceleration and acceleration time), as well as the outcomes of AVFs placed on calcified arteries. It is concluded that a noninvasive ultrasound examination is probably the best tool for a morphologic and functional assessment of the arteries. An arterial assessment is of utmost importance if we are to create distal radiocephalic AVFs in our elderly patients whenever possible without burdening them with futile surgical attempts.https://www.mdpi.com/2075-4418/13/16/2660arterio-venous fistulaultrasoundmappingarterial calcificationsmediocalcinosisDoppler |
| spellingShingle | Jakob Gubensek The Role of Ultrasound Examination in the Assessment of Suitability of Calcified Arteries for Vascular Access Creation—Mini Review Diagnostics arterio-venous fistula ultrasound mapping arterial calcifications mediocalcinosis Doppler |
| title | The Role of Ultrasound Examination in the Assessment of Suitability of Calcified Arteries for Vascular Access Creation—Mini Review |
| title_full | The Role of Ultrasound Examination in the Assessment of Suitability of Calcified Arteries for Vascular Access Creation—Mini Review |
| title_fullStr | The Role of Ultrasound Examination in the Assessment of Suitability of Calcified Arteries for Vascular Access Creation—Mini Review |
| title_full_unstemmed | The Role of Ultrasound Examination in the Assessment of Suitability of Calcified Arteries for Vascular Access Creation—Mini Review |
| title_short | The Role of Ultrasound Examination in the Assessment of Suitability of Calcified Arteries for Vascular Access Creation—Mini Review |
| title_sort | role of ultrasound examination in the assessment of suitability of calcified arteries for vascular access creation mini review |
| topic | arterio-venous fistula ultrasound mapping arterial calcifications mediocalcinosis Doppler |
| url | https://www.mdpi.com/2075-4418/13/16/2660 |
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