Abstract:
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Recently, Brescia-Cimino shunt has been recommended to be a first choice hemodialysis access. However, IVR of Brescia-Cimino shunt is more difficult than that of graft hemodialysis access. We performed color doppler ultrasound prior to IVR of Brescia-Cimino shunt insufficiency in 400 cases, and proved it to be useful in planning IVR. We could visualize the site of stenois, the extent of thrombus to be treated by mechanical thrombectomy or pharmacomechanical thrombolysis by US. Entire course of the shunt including stenosed or occluded vein and their continuity to normal drainage vein was recognized much better than palpation or auscultation, enabling determination of ideal puncture site, simplify catheter manipulation to pass through the lesion. Basic techniques and characteristic ultrasound findings of normal and various types of failed hemodialysis access will be illustrated. We will describe the knowledge of ultrasound findings in detecting stenosis, characterizing type of occlusion (thrombotic or non-thrombotic), estimating central arterial or venous lesion. Various cases where ultrasound was useful in performing IVR will be demonstrated.
1. To understand ultrasound findings of normal and failed Brescia-Cimino hemodialysis access. 2. Become familiar with the technique to visualize hemodialysis access insufficiency. 3. To learn the findings of various types of hemodialysis access insufficiency at ultrasound imaging. 4. Demonstrate the role of ultrasound as a pre-procedural imaging for hemodialysis access intervention.
Questions about this event email: kytakase@mb.infoweb.ne.jp
Takase MD, K,
How to Utilize Color Doppler Ultrasound in IVR of Brescia-Cimino Shunt. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3104332.html
