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  • Purpose: Patency of mature vascular access for hemodialysis is mostly limited by the growing stenoses leading to acute access thrombosis. The therapy of choice is usually percutaneous balloon angioplasty (PTA). However, PTA injures the vessel wall and subsequent re-stenosis develops faster than de novo stenosis. Therefore, the key is in appropriate timing of PTA procedures - as late as possible but before access thrombosis develops. Ultrasonography combines the morphologic and functional access assessment, but the former is less precise than angiography. The aim of this study was to compare ultrasonographic and angiographic measuring of residual diameter as the additional criterion of significant stenoses used in our center. Methods: Residual diameter of significant stenoses was measured by B-mode ultrasonography three times in 20 patients. All the patients were indicated for angiography and the residual diameter of the stenoses was re-analyzed by this method. The repeatability of ultrasonographic residual diameter measurements and reproducibility in comparison to angiography were expressed by coefficients of variation (CV). Results: The residual diameter was 1.69 +/- 0.05 mm by ultrasound and 1.65 +/- 0.59 mm measured by angiography. In the ultrasound repeatability study, CV was 3.17 +/- 2.76% and in the reproducibility study CV was 18.0 +/- 15.6%. All the stenoses found to be significant by ultrasound were above 65% by angiography and PTA was performed. Conclusions: Ultrasonographic measurement of the residual diameter is stable in experienced hands and is well comparable to angiography results. These findings advocate residual diameter of 2.0 mm as the strong additional criterion of the significant stenoses, which can also be used in ultrasound surveillance of arteriovenous grafts.
  • Purpose: Patency of mature vascular access for hemodialysis is mostly limited by the growing stenoses leading to acute access thrombosis. The therapy of choice is usually percutaneous balloon angioplasty (PTA). However, PTA injures the vessel wall and subsequent re-stenosis develops faster than de novo stenosis. Therefore, the key is in appropriate timing of PTA procedures - as late as possible but before access thrombosis develops. Ultrasonography combines the morphologic and functional access assessment, but the former is less precise than angiography. The aim of this study was to compare ultrasonographic and angiographic measuring of residual diameter as the additional criterion of significant stenoses used in our center. Methods: Residual diameter of significant stenoses was measured by B-mode ultrasonography three times in 20 patients. All the patients were indicated for angiography and the residual diameter of the stenoses was re-analyzed by this method. The repeatability of ultrasonographic residual diameter measurements and reproducibility in comparison to angiography were expressed by coefficients of variation (CV). Results: The residual diameter was 1.69 +/- 0.05 mm by ultrasound and 1.65 +/- 0.59 mm measured by angiography. In the ultrasound repeatability study, CV was 3.17 +/- 2.76% and in the reproducibility study CV was 18.0 +/- 15.6%. All the stenoses found to be significant by ultrasound were above 65% by angiography and PTA was performed. Conclusions: Ultrasonographic measurement of the residual diameter is stable in experienced hands and is well comparable to angiography results. These findings advocate residual diameter of 2.0 mm as the strong additional criterion of the significant stenoses, which can also be used in ultrasound surveillance of arteriovenous grafts. (en)
Title
  • More precise diagnosis of access stenosis: ultrasonography versus angiography
  • More precise diagnosis of access stenosis: ultrasonography versus angiography (en)
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  • More precise diagnosis of access stenosis: ultrasonography versus angiography
  • More precise diagnosis of access stenosis: ultrasonography versus angiography (en)
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  • RIV/00064165:_____/12:13561!RIV13-MZ0-00064165
http://linked.open...avai/predkladatel
http://linked.open...avai/riv/aktivita
http://linked.open...avai/riv/aktivity
  • I, P(NS10590)
http://linked.open...iv/cisloPeriodika
  • 3
http://linked.open...vai/riv/dodaniDat
http://linked.open...aciTvurceVysledku
http://linked.open.../riv/druhVysledku
http://linked.open...iv/duvernostUdaju
http://linked.open...titaPredkladatele
http://linked.open...dnocenehoVysledku
  • 151810
http://linked.open...ai/riv/idVysledku
  • RIV/00064165:_____/12:13561
http://linked.open...riv/jazykVysledku
http://linked.open.../riv/klicovaSlova
  • Angiography; Duplex Doppler ultrasound; Hemodialysis vascular access; Residual diameter; Significant stenosis; hemodialysis vascular access; percutaneous transluminal angioplasty; internal carotid-artery; ultrasound surveillance; neointimal hyperplasia; arteriovenous grafts; ptfe grafts; blood-flow; short-term; patency (en)
http://linked.open.../riv/klicoveSlovo
http://linked.open...odStatuVydavatele
  • IT - Italská republika
http://linked.open...ontrolniKodProRIV
  • [C074B4D3EBCC]
http://linked.open...i/riv/nazevZdroje
  • Journal of Vascular Access
http://linked.open...in/vavai/riv/obor
http://linked.open...ichTvurcuVysledku
http://linked.open...cetTvurcuVysledku
http://linked.open...vavai/riv/projekt
http://linked.open...UplatneniVysledku
http://linked.open...v/svazekPeriodika
  • 13
http://linked.open...iv/tvurceVysledku
  • Kudlička, Jaroslav
  • Malík, Jan
  • Tuka, Vladimír
  • Kaván, Jan
http://linked.open...ain/vavai/riv/wos
  • 000310197200009
issn
  • 1129-7298
number of pages
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