Current status and prospect of clinical application of ultrasound technology in arteriovenous fistula for hemodialysis

doi:10.3877/cma.j.issn.2095-3216.2022.02.009

Abstract

Abstract:

Arteriovenous fistula (AVF) is the preferred vascular access for maintenance hemodialysis (MHD) in patients with end-stage renal disease (ESRD). The vascular selection and evaluation before AVF establishment, the maturity assessment after AVF establishment, the timely treatment of AVF mature disorders, and the timely monitoring, location, and treatment of complications during AVF use, are all crucial for the MHD treatment. Ultrasound has the advantages of convenience, non-invasiveness, safety, and economy in evaluating vascular anatomy and blood flow, and is helpful for selecting AVF vessels, assessing the maturity of AVF, discovering the AVF maturity disorders and their causes, detecting and locating postoperative complications, guiding the treatment of mature disorders and complications, improving the success rate of AVF establishment, and ensuring the proceeding of MHD. This article reviewed the current status and prospect of the clinical application of conventional ultrasound and contrast-enhanced ultrasound (CEUS) in the AVF of MHD patients in recent years.

Key words: Arteriovenous fistula, Ultrasound, Contrast-enhanced ultrasound

Nan Li, Mengke Zhang, Yanting Lv, Yongjiao Ji, Zhifang Ma, Lingling Long, Shasha Wang, Miao Zhang, Hanyu Zhu, Yukun Luo. Current status and prospect of clinical application of ultrasound technology in arteriovenous fistula for hemodialysis[J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2022, 11(02): 99-103.

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References 36

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来源	静脉内径	动脉内径
欧洲MHD指南	≥2 mm	≥2 mm
Lee等^[5]	<2 mm与≥2 mm均可	-
K/DOQI指南	≥2.5 mm	≥2 mm
国内标准	≥2 mm	≥1.6 mm

来源	静脉内径	动脉内径
欧洲MHD指南	≥2 mm	≥2 mm
Lee等^[5]	<2 mm与≥2 mm均可	-
K/DOQI指南	≥2.5 mm	≥2 mm
国内标准	≥2 mm	≥1.6 mm

来源	静脉内径	动脉血流量	静脉与皮肤距离	用于穿刺的静脉长度
Robbin等^[13]	≥4 mm	≥500 ml/min	-	-
K/DOQI指南	>6 mm	>600 ml/min	<6 mm	>60 mm
英国肾病学会血液透析血管通路临床指南	>5 mm	>500 ml/min	-	-
国内共识	≥5 mm	>500 ml/min	<6 mm	-

来源	静脉内径	动脉血流量	静脉与皮肤距离	用于穿刺的静脉长度
Robbin等^[13]	≥4 mm	≥500 ml/min	-	-
K/DOQI指南	>6 mm	>600 ml/min	<6 mm	>60 mm
英国肾病学会血液透析血管通路临床指南	>5 mm	>500 ml/min	-	-
国内共识	≥5 mm	>500 ml/min	<6 mm	-

来源	标准
士拉斯等^[25]	引流静脉狭窄：狭窄发生处与其向下2 cm血管处SVR>2
	吻合口或流入动脉狭窄：狭窄发生处与其向上2 cm血管处SVR>3
Wo等^[26]	狭窄率≥50%：PSV≥500 cm/s
Fahrtash等^[27]	静脉内径<2.7 mm，流入动脉内径<3 mm
Chen等^[28]	可触脉长度(脉搏难触到处到吻合口的距离)<11.0 cm
	可触脉长度与吻合口距动脉插管处距离的比值<1.29

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