Department of Vascular Accesses for Hemodialysis, Nephrocare Italy, Naples, Italy.
UOC Dialisi con Complicazioni Cardio Pneumologiche, P.O. Monaldi, AORN dei Colli, Naples, Italy.
J Vasc Access. 2024 Nov;25(6):1721-1740. doi: 10.1177/11297298231178588. Epub 2023 Oct 9.
Although arteriovenous fistula (AVF) continues to be the vascular access of choice for the hemodialysis, arteriovenous graft (AVG) can be the best choice in certain categories of patients and could have several advantages over AVF in a "patient centered approach" to vascular access. In the clinical management of prosthetic fistulas, color Doppler ultrasound (CDU) is the imaging method of choice for identifying stenosis and other AVG complications. In this review, besides highlighting the pivotal role of CDU in the diagnosis of AVG complications, we will underline the key role that ultrasound can play in identifying those stenosis most likely to cause AVG thrombosis. Furthermore, we will emphasize the support that CDU can play in distinguishing the different types of grafts and prosthetic devices such as stent-grafts, in identifying AVG with lower survival, CDU utilities and limitations in the evaluation of freshly-implanted grafts, the different sites available for AVG volume flow measurement and their use based on the configuration of the prosthesis, the time interval elapsed from the surgical intervention and the integrity of the prosthetic walls.
虽然动静脉瘘（AVF）仍然是血液透析的首选血管通路，但在某些特定类别患者中，动静脉移植物（AVG）可能是最佳选择，在“以患者为中心的血管通路方法”中，AVG 可能具有几个优势。在人工动静脉瘘的临床管理中，彩色多普勒超声（CDU）是识别狭窄和其他 AVG 并发症的首选成像方法。在本综述中，除了强调 CDU 在诊断 AVG 并发症中的关键作用外，我们还将强调超声在识别最有可能导致 AVG 血栓形成的狭窄方面的关键作用。此外，我们将强调 CDU 在区分不同类型的移植物和假体装置（如支架移植物）、识别存活率较低的 AVG、CDU 在评估新植入移植物中的用途和局限性、用于 AVG 体积流量测量的不同部位以及基于假体配置的使用、从手术干预到假体壁完整性的时间间隔等方面的作用。
