Abstract: SA-PO1085
The Importance of Monitoring Blood Flow in the Maintenance of Vascular Access in Patients Under Hemodialysis
Session Information
- Vascular Access - II
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 704 Dialysis: Vascular Access
Author
- Griveas, Ioannis, 417 Army Share Fund Hospital, Athens, Greece
Background
The usefulness of blood flow monitoring (QA) in arteriovenous fistula (AVF) of patients with End Stage Renal Disease (ESRD) under hemodialysis (HD) patients is a current controversy in the international literature. Although all of the clinical guidelines for vascular access include monitoring protocols to prevent thrombosis (VA), randomized clinical trials (RCTs) have failed to consistently demonstrate the benefits of QA-based surveillance protocols. We present our experience of evaluating the usefulness of QA measurement using Doppler (DU) ultrasound in patients under HD.
Methods
168 patients from two HD centers were under follow up for 3 years. The classic QA tracking method was applied to all once a year and moretimes on clinical indications. The episodes of thrombosis in vascular access that occurred acutely (group 1) and the interventions episodes made on the basis of DU findings (group 2) were recorded.
Results
During the 3-year follow-up period, 24 interventions were required to restore the functioning of vascular access. Of these, 8 were made after an acute event (group 1) and 16 after a finding derived from a DU control (group 2). Of the 8 acute cases of AVF or graft thrombosis, 5 ended up with a central venous catheter. Of the 16 cases requiring intervention after an ultrasound finding 12 events maintained the type of vascular access they had and 4 ended up with a central venous catheter. Group 1 required hospitalization of more than one day in 3 cases, which did not occur in any of Group 2 incidents.
Conclusion
Periodic QA measurement using DU significantly helps maintain vascular access of patients, limiting their days of hospitalization and significantly contributing to their better quality of life.