Shilpa Nagarur Reddy MD, Presenter: Nothing to Disclose

Meghan Boros MD, Abstract Co-Author: Nothing to Disclose

Mindy Meislich Horrow MD, Abstract Co-Author: Spouse, Director, Merck & Co, Inc

1. Venous US is frequently the initial study requested to evaluate acute arm swelling in patients with dialysis access 2. While important to exclude DVT, , in the setting of swelling in an arm with chronic dialysis access, radiologists must consider a wide variety of other vascular and non-vascular causes for swelling, many of which can be appreciated or suggested using US 3. This exhibit will review anatomy of AV grafts and fistulas and how to evaluate them with US, demonstrate examples of alternative vascular and non-vascular diagnoses, and discuss when other modalities and interventions are necessary  

1. Systematic approach using US for initial evaluation of swollen arm with chronic dialysis access a. History and physical examination of arm b. Type of access c. Relevant vascular anatomy with Doppler analysis d. Soft tissues 2. Venous related diagnoses a. Deep and superficial venous thrombosis b. Central venous stenosis or occlusion c. Large draining veins from fistula 3. Abnormalities intrinsic to chronic dialysis access a. Thrombosis of fistula or graft b. Steal syndrome c. PSA 4. Non-vascular diagnoses a. Soft tissue collections b. Other arm masses  

http://abstract.rsna.org/uploads/2014/14001317/14001317_iaui.pdf

Reddy, S, Boros, M, Horrow, M, Imaging the Swollen Arm with Dialysis Access: It’s Not Just DVT.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14001317.html