Niyyar Vandana Dua, Wasse Haimanot
Emory University, Atlanta, Georgia.
Rush University, Chicago, Illinois.
Semin Dial. 2017 Jul;30(4):305-308. doi: 10.1111/sdi.12594. Epub 2017 Apr 5.
The population of patients with end-stage renal disease (ESRD) in the United States is progressively increasing, with hemodialysis (HD) as the major mode of renal replacement therapy. National guidelines recommend increasing the use of arteriovenous fistulae (AVF) in both incident and prevalent hemodialysis patients. Pre-operative vascular mapping prior to the surgical creation of an AVF is now considered standard of care and may be helpful in achieving these goals. This manuscript focuses on the advantages and limitations of the various imaging techniques currently available for vessel mapping including physical examination, ultrasonography, angiography (iodinated contrast vs. CO ), and magnetic resonance angiography (MRA), with specific suggestions for clinical use.
美国终末期肾病(ESRD)患者群体正在逐步增加,血液透析(HD)是主要的肾脏替代治疗方式。国家指南建议在新发病例和长期血液透析患者中增加动静脉内瘘(AVF)的使用。在手术创建AVF之前进行术前血管造影现在被视为标准治疗方法,可能有助于实现这些目标。本文着重介绍目前可用于血管造影的各种成像技术的优缺点,包括体格检查、超声检查、血管造影(碘化造影剂与CO对比)和磁共振血管造影(MRA),并给出临床使用的具体建议。