Institute of Life sciences, Department of Internal Medicine, Sant'Anna School of Advanced Studies, University of Pisa, Pisa, Italy.
Nephrology Department, Parc Taulí University Hospital, Parc Taulí Research and Innovation Institute (I3PT), Autonomous University of Barcelona, Barcelona, Spain.
J Vasc Access. 2021 Nov;22(1_suppl):56-62. doi: 10.1177/11297298211034638. Epub 2021 Jul 21.
Physical examination (PE) is considered the backbone before vascular access (VA) placement, during maturation period and for follow-up. However, it may be inadequate in identifying suitable vasculature, mainly in comorbid patients, or in detecting complications. This review highlights the advantages of ultrasound imaging to manage VA before placement, during maturation and follow-up. Furthermore, it analyses the future perspectives in evaluating early and late VA complications thank to the availability of multiparametric platforms, point of care of ultrasound, and portable/wireless systems. Technical improvements and low-cost systems should favor the widespread ultrasound-based VA surveillance programs. This significant turning point needs an adequate training of nephrologists and dialysis nurses and the standardization of exams, parameters, and procedures.
体格检查（PE）被认为是血管通路（VA）置管前、成熟期间和随访的基础。然而，它可能无法充分识别合适的血管，特别是在合并症患者中，或检测并发症。本综述强调了超声成像在 VA 置管前、成熟期间和随访期间管理中的优势。此外，它还分析了由于多参数平台、即时超声和便携式/无线系统的可用性，评估早期和晚期 VA 并发症的未来前景。技术改进和低成本系统应有利于广泛开展基于超声的 VA 监测计划。这一重大转折点需要肾科医生和透析护士的充分培训以及检查、参数和程序的标准化。
