Besarab A, Lubkowski T, Ramanathan S, Frinak S, Escobar F
Detection of access strictures and outlet stenoses in
vascular access: which test is best?
43rd Annual ASAIO Conference, Atlanta
ASAIO J
(Apr) 43:69 1997
This study adds to the accumulating body of evidence that measurement of
access blood flow rate is the best detector of stenosis, and thus best
predictor of thrombosis. This particular study is directed at grafts
and fistulas with a stricture in the access itself, rather than in the
more usual position at the venous outlet. It is not entirely clear what
this might mean in an AV fistula; presumably a stenosis in the principal
outlet vein between usual needle sites.
The results (at least in
grafts) are not surprising--recirculation was absent and intra-access
pressures were frequently normal, but access blood flow (measured with
the Transonic flowmeter) was markedly reduced--exactly what one would
expect with a stenosis between the arterial and venous needles. One
looks forward to the day when access flow measurement technology will be
integrated into dialysis delivery systems.
(Robert H. Barth, M.D., VA Medical Center, Brooklyn, NY)
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43rd Annual ASAIO Conference, Atlanta
Basic hemodialysis :
Vascular Access: graft/fistula