Vascular access is absolutely essential for haemodialysis due to its relationship with quality of dialysis and associated morbidity. Therefore, it must be monitored and continuously surveilled from the moment it is created to prevent failure in maturation and thrombosis. Multidisciplinary collaboration is necessary when the main aim is to achieve the adequate vascular access flow with the fewest possible complications. The starting point, and probably the main one, is vascular access planning. This planning requires both a deep understanding of the anatomy of the upper limb and enough skill to examine it by Doppler ultrasound. The aim of this article is to review the anatomical and haemodynamical concepts of the arterial and venous vascular tree and explain how to perform ultrasound mapping, optimising the technical resources provided by this tool. Likewise, adequate access creation criteria that minimise the risk of failure and associated complications will be discussed.
Rodríguez-OlayJ.Estudio preoperatorio del paciente: examen físico y pruebas de imagen. Angiologia2005; 57(Suppl 2): 23–34.
3.
IbeasJRoca-TeyRVallespínJ, et al.; por el Grupo Español Multidisciplinar del Acceso Vascular (GEMAV). Spanish clinical guidelines on vascular access for haemodialysis. Nefrologia2017; 37(Suppl 1): 1–191.
4.
MihmanliIBesirliKKurugogluS, et al. Cephalic vein and hemodialysis fistula: surgeon’s observation versus color Doppler ultrasonographic findings. J Ultrasound Med2001; 20(3): 217–222.
5.
HossainSSharmaADuboisL, et al. Preoperative point-of-care ultrasound and its impact on arteriovenous fistula maturation outcomes. J Vasc Surg2018; 68(4): 1157–1165.
6.
GeorgiadisGSCharalampidisDGArgyriouC, et al. The necessity for routine preoperative ultrasound mapping before arteriovenous fistula creation: a meta-analysis. Eur J Vasc Endovasc Surg2015; 49(5): 600–605.
7.
El KhouryRRusseauAPPatelN, et al. Reliability of preoperative venous mapping ultrasonography in predicting for autogenous arteriovenous fistula maturation. J Vasc Surg2021; 73(5): 1787–1793.
8.
KosaSDAl-JaishiAAMoistL, et al. Preoperative vascular access evaluation for haemodialysis patients. Cochrane Database Syst Rev2015Sep30; 2015(9): CD007013.
9.
LokCEHuberTSLeeT, et al.; National Kidney Foundation. KDOQI clinical practice guideline for vascular access: 2019 update. Am J Kidney Dis2020; 75(4Suppl 2): S1–S164.
10.
SchmidliJWidmerMKBasileC, et al. Editor’s choice – vascular access: 2018 clinical practice guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg2018; 55(6): 757–818.
11.
Ibeas-LópezJVallespín-AguadoJ.Formación continuada en nefrología. Ecografía del acceso vascular para hemodiálisis: conceptos teóricos y prácticos, Criterios. Nefrol Sup Ext2012; 3(6): 21–35.
12.
ShenoyS.Surgical anatomy of upper arm: what is needed for AVF planning. J Vasc Access2009; 10(4): 223–232.
13.
FeneisHDauberWCourtissEH. Pocket atlas of human anatomy: based on the international nomenclature. Plast Reconstr Surg1987; 79(6): 999.
14.
MalovrhM.The role of sonography in the planning of arteriovenous fistulas for hemodialysis. Semin Dial2003; 16(4): 299–303.
15.
GallieniMHollenbeckMInstonN, et al. Clinical practice guideline on peri- and postoperative care of arteriovenous fistulas and grafts for haemodialysis in adults. Nephrol Dial Transplant2020; 35(12): 2203–2203.
16.
LauvaoLSIhnatDMGoshimaKR, et al. Vein diameter is the major predictor of fistula maturation. J Vasc Surg2009; 49(6): 1499–1504.
17.
AbreuRRiojaSVallespinJ, et al. Predictors of early failure and secondary patency in native arteriovenous fistulas for hemodialysis. Int Angiol2018; 37(4): 310–314.
18.
FeldmanHIJoffeMRosasSE, et al. Predictors of successful arteriovenous fistula maturation. Am J Kidney Dis2003; 42(5): 1000–1012.
19.
FarringtonCARobbinMLLeeT, et al. Early predictors of arteriovenous fistula maturation: a novel perspective on an enduring problem. J Am Soc Nephrol2020; 31(7): 1617–1627.
20.
SmithGEGohilRChetterIC.Factors affecting the patency of arteriovenous fistulas for dialysis access. J Vasc Surg2012; 55(3): 849–855.
21.
WaheedAMasenguASkalaT, et al. A prospective cohort study of predictors of upper extremity arteriovenous fistula maturation. J Vasc Access2020; 21(5): 746–752.
22.
JemcovTK.Morphologic and functional vessels characteristics assessed by ultrasonography for prediction of radiocephalic fistula maturation. J Vasc Access2013; 14(4): 356–363.
SedlacekMTeodorescuVFalkA, et al. Hemodialysis access placement with preoperative noninvasive vascular mapping: comparison between patients with and without diabetes. Am J Kidney Dis2001; 38(3): 560–564.
LockhartMERobbinMLAllonM.Preoperative sonographic radial artery evaluation and correlation with subsequent radiocephalic fistula outcome. J Ultrasound Med2004; 23(2): 161–168; quiz 169.
27.
WallLPGasparisACallahanS, et al. Impaired hyperemic response is predictive of early access failure. Ann Vasc Surg2004; 18(2): 167–171.
28.
LorenzMWMarkusHSBotsML, et al. Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis. Circulation2007; 115(4): 459–467.
29.
JohriAMNambiVNaqviTZ, et al. Recommendations for the assessment of carotid arterial plaque by ultrasound for the characterization of atherosclerosis and evaluation of cardiovascular risk: from the American Society of Echocardiography. J Am Soc Echocardiogr2020; 33(8): 917–933.
30.
KuYMKimYOKimJI, et al. Ultrasonographic measurement of intima-media thickness of radial artery in pre-dialysis uraemic patients: comparison with histological examination. Nephrol Dial Transplant2006; 21(3): 715–720.
31.
FilaBRoca-TeyRMalikJ, et al. Quality assessment of vascular access procedures for hemodialysis: a position paper of the Vascular Access Society based on the analysis of existing guidelines. J Vasc Access2020; 21(2): 148–153.
