A systematic review of preoperative duplex ultrasonography and arteriovenous fistula formation

Chee Siong Wong, Nuala McNicholas, Donagh Healy, Mary Clarke-Moloney, J. Calvin Coffey, Pierce A. Grace, Stewart R. Walsh

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Arteriovenous fistula (AVF) formation for dialysis access is a common procedure. Fistula maturation is unpredictable. Preoperative duplex mapping may increase procedural success. We undertook a systematic review to assess the effect of preoperative duplex mapping on subsequent AVF patency. Methods: The published literature was searched on PubMed and the Cochrane Library using the following keywords: 'arteriovenous fistula,' 'venous mapping,' 'ultrasound,' 'hemodialysis,' 'vascular access,' and 'perioperative vessel mapping.' Conference proceedings were hand searched for otherwise unpublished trials. Only randomized controlled trials in which preoperative duplex mapping was compared with clinical evaluation were eligible. Results: Three trials (402 patients) were identified. More patients who underwent ultrasound successfully started using their fistula for dialysis access, although the difference did not reach statistical significance (174/214 vs 130/188; pooled odds ratio, 1.96; P =.11). Conclusions: Preoperative duplex mapping may improve fistula maturation rates. However, the results do not reach statistical significance and there are no cost-effectiveness data. Further work is required.

Original languageEnglish
Pages (from-to)1129-1133
Number of pages5
JournalJournal of Vascular Surgery
Volume57
Issue number4
DOIs
Publication statusPublished - Apr 2013

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