Color doppler US evaluation of feeding artery after balloon angioplasty of the drainage vein in dysfunctional hemodialysis AVF

Abstract

Purpose. The aim of this study was to investigate flow rate and resistive index (RI) parameters of the feeding artery after balloon angioplasty of the drainage vein in dysfunctional hemodialysis arteriovenous fistula (AVF) due to venous stenosis/thrombosis. Methods. A cohort of 10 patients with native dysfunctional hemodialysis AVF was evaluated prospectively. Three of the 10 patients had a thrombosed drainage vein, and the remaining seven patients had a stenotic drainage vein. Flow rate and RI of the feeding artery of AVF were calculated by Color Doppler ultrasound (CDU) before and after balloon angioplasty and in the follow-up period. The flow rates and RI values before and after angioplasty and in the follow-up were compared. Results. Increased flow rate and decreased RI values were detected after balloon angioplasty in all patients. We detected restenosis or thrombosis of drainage vein in six of the patients in the follow-up period. Decreased flow rate and increased RI values compared with previous measurements were calculated in these patients. Conclusions. Increased flow rate and decreased RI in the feeding artery of native dysfunctional AVF were demonstrated in patients who underwent balloon angioplasty on the stenotic vein. If restenosis develops in the follow-up period, the previous high resistance flow pattern is observed again. Feeding artery flow parameters as calculated by CDU can be used as a simple indicator of possible drainage vein problems of native AVF. Copyright © Informa Healthcare USA, Inc.