SP589PREDIALYSIS VASCULAR ACCESS CREATION. TO WHOM AND WHEN Article Swipe
YOU?
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· 2017
· Open Access
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· DOI: https://doi.org/10.1093/ndt/gfx153.sp589
· OA: W2619169330
INTRODUCTION AND AIMS: Blood flow assessment with Duplex Doppler Ultrasound (DDU) is a valuable tool for hemodialysis vascular access surveillance according to K/DOQI guidelines; however, due to its operator-dependency and the technical difficulties associated to the procedure, it is scarcely applicable as part of the routine surveillance strategy.Smart Flow is a new tool available on Carestream Touch Prime ultrasound machines, which provides automated blood flow measurement, independently from the insonation angle.The aim of this study was to compare DDU and Smart flow in routine vascular access surveillance in hemodialysis patients.METHODS: Fourteen patients on chronic hemodialysis with a functioning arteriovenous fistula underwent the examination.Blood flow was measured on the brachial artery, as a mean of three measurements, with both Smart Flow and DDU, by a single trained operator.Measurements were performed with Carestream Touch Prime ultrasound machine for both techniques.Time needed to achieve three valid measurements of blood flow was recorded for each technique.RESULTS: Mean age of examined fistulas was 84.1665.7 months.Measurements performed with Smart Flow and DDU showed a good positive correlation (p<0.0001).Average time to perform the examination was significantly faster for Smart Flow (97632 seconds) than for DDU (205660 seconds) (p<0.0001).Mean standard deviation (SD) for Smart Flow was 132.46108.6 ml/min, while mean SD for DDU was 182.16168.2ml/min (p=0.24).However, SD tended to increase with higher blood flow for DDU (p=0.0005) but not for Smart Flow (p=0.09).CONCLUSIONS: Smart Flow is comparable to Duplex Doppler Ultrasound for blood flow assessment in arteriovenous fistulas, allowing the examination to be performed in less than half of the time.Reproducibility of the results seems to be comparable between the two techniques but Smart flow showed a better performance for higher blood flows.Thus, Smart flow may represent a simple, fast and reliable tool for routine hemodialysis vascular access surveillance.
