Stenosis is the most frequent vascular access complication and is responsible for access thrombosis and thus long-term patency limitation. Regular arteriovenous graft (AVG) examination by ultrasonography and preemptive balloon angioplasty prolong AVG cumulative patency according to some, but by far not all trials. This was why the routine use of ultrasound surveillance is not recommended recently.
In this review we show huge differences in the definition of stenosis significance among the trials and other probable factors, which may have caused the contradiction of the results. Without precise definition of stenosis significance, many AVGs have been undergoing unnecessary balloon interventions with high morbidity, high cost and low benefit.
MalikJ., SlavikovaM., MalikovaH., MaskovaJ.Many clinically silent access stenoses can be identified by ultrasonography.J Nephrol.2002; 15(6): 661–665.
4.
PaulsonW.D., RamS.J., BirkC.G., ZapczynskiM., MartinS.R., WorkJ.Accuracy of decrease in blood flow in predicting hemodialysis graft thrombosis.Am J Kidney Dis.2000; 35(6): 1089–1095.
5.
Tonelli M, James M, Wiebe N, Jindal K, Hemmelgarn B; Alberta Kidney Disease Network.Ultrasound monitoring to detect access stenosis in hemodialysis patients: a systematic review.Am J Kidney Dis.2008; 51(4): 630–640.
6.
KumbarL., KarimJ., BesarabA.Surveillance and monitoring of dialysis access.Int J Nephrol2012; 2012: 649735.
7.
WorkJ.Role of access surveillance and preemptive intervention.Semin Vasc Surg.2011; 24(2): 137–142.
8.
SchildA.F.Maintaining vascular access: the management of hemodialysis arteriovenous grafts.J Vasc Access.2010; 11(2): 92–99.
AllonM., RobbinM.L.Hemodialysis vascular access monitoring: current concepts.Hemodial Int.2009; 13(2): 153–162.
11.
StrauchB.S., O'ConnellR.S., GeolyK.L., GrundlehnerM., YakubY.N., TietjenD.P.Forecasting thrombosis of vascular access with Doppler color flow imaging.Am J Kidney Dis.1992; 19(6): 554–557.
12.
GadallahM.F., PaulsonW.D., VickersB., WorkJ.Accuracy of Doppler ultrasound in diagnosing anatomic stenosis of hemodialysis arteriovenous access as compared with fistulography.Am J Kidney Dis.1998; 32(2): 273–277.
13.
KudlickaJ., KavanJ., TukaV., MalikJ.More precise diagnosis of access stenosis: ultrasonography versus angiography.J Vasc Access.2012; 13(3): 310–314.
14.
TukaV., MalikJ., ChytilovaE.Long-term arterial adaptation to high blood flow in the feeding artery of vascular access for hemodialysis.J Vasc Access.2012; 13(3): 305–309.
15.
LacsonE.Jr., WangW., LazarusJ.M., HakimR.M.Change in vascular access and hospitalization risk in long-term hemodialysis patients.Clin J Am Soc Nephrol.2010; 5(11): 1996–2003.
ChawlaA., DiRaimoR., PanettaT.F.Balloon angioplasty to facilitate autogenous arteriovenous access maturation: a new paradigm for upgrading small-caliber veins, improved function, and surveillance.Semin Vasc Surg.2011; 24(2): 82–88.
18.
MalikJ., TukaV., TesarV.Local hemodynamics of the vascular access for hemodialysis.Kidney Blood Press Res.2009; 32(1): 59–66.
19.
MayerD.A., ZingaleR.G., TsapogasM.J.Duplex scanning of expanded polytetrafluoroethylene dialysis shunts: impact on patient management and graft survival.Vasc Endovasc Surg.1993; 27(9): 647–658.
20.
LumsdenA.B., MacDonaldM.J., KikeriD., CotsonisG.A., HarkerL.A., MartinL.G.Prophylactic balloon angioplasty fails to prolong the patency of expanded polytetrafluoroethylene arteriovenous grafts: results of a prospective randomized study.J Vasc Surg.1997; 26(3): 382–390, discussion 390-392.
21.
RamS.J., WorkJ., CalditoG.C., EasonJ.M., PervezA., PaulsonW.D.A randomized controlled trial of blood flow and stenosis surveillance of hemodialysis grafts.Kidney Int.2003; 64(1): 272–280.
22.
DossabhoyN.R., RamS.J., NassarR., WorkJ., EasonJ.M., PaulsonW.D.Stenosis surveillance of hemodialysis grafts by duplex ultrasound reduces hospitalizations and cost of care.Semin Dial.2005; 18(6): 550–557.
23.
RobbinM.L., OserR.F., LeeJ.Y., HeudebertG.R., MennemeyerS.T., AllonM.Randomized comparison of ultrasound surveillance and clinical monitoring on arteriovenous graft outcomes.Kidney Int.2006; 69(4): 730–735.
24.
BayW.H., HenryM.L., LazarusJ.M., LewN.L., LingJ., LowrieE.G.Predicting hemodialysis access failure with color flow Doppler ultrasound.Am J Nephrol.1998; 18(4): 296–304.
JiangS., StewartG., BarnesE., JardineM., RazavianM., GallagherM.Effect of a vascular access surveillance program on service provision and access thrombosis.Semin Dial.2013; 26(3): 361–365.
27.
TukaV., SlavikovaM., KrupickovaZ., MokrejsovaM., ChytilovaE., MalikJ.Short-term outcomes of borderline stenoses in vascular accesses with PTFE grafts.Nephrol Dial Transplant.2009; 24(10): 3193–3197.
28.
van HoolandS., MalikJ.Hemodialysis vascular access ultrasonography: tips, tricks, pitfalls and a quiz.J Vasc Access.2010; 11(4): 255–262.
29.
ShintakuS.K.H., MoriishiM., AgohR., BansyodaniM., TsuchiyaS.Flow volume and resistance index help predict early access failure in arteriovenous fistulae.J Vasc Access.2013; 14(1): 61–62.
30.
RobbinM.L., OserR.F., AllonM.Hemodialysis access graft stenosis: US detection.Radiology.1998; 208(3): 655–661.
31.
ShenoyS., HogansonD., HinkelD.Validation of computation fluid dynamics based analysis to evaluate hemodynamic significance of access stenosis.J Vasc Access.2013; 14(1): 28.
32.
Turmel-RodriguesL., PengloanJ., BaudinS.Treatment of stenosis and thrombosis in haemodialysis fistulas and grafts by interventional radiology.Nephrol Dial Transplant.2000; 15(12): 2029–2036.
33.
RenaudC.J., FrancoisM., NonyA., Fodil-CherifM., Turmel-RodriguesL.Comparative outcomes of treated symptomatic versus non-treated asymptomatic high-grade central vein stenoses in the outflow of predominantly dialysis fistulas.Nephrol Dial Transplant.2012; 27(4): 1631–1638.
