Abstract
Introduction
The use of preoperative vein mapping for arteriovenous fistula creation has shown promise in multiple studies over the years. However, a definitive scanning technique has not been well described. Our center has developed a standard method of preoperative vein mapping performed by a select group of trained technologists. Together with a single surgeon, we believe that this technique is equivalent to if not better than previously described methods.
Methods
In a retrospective study of 88 patients, all patients underwent preoperative scanning according to our dialysis mapping protocol with subsequent operative intervention.
Results
Eighty-three of the 88 patients mapped correctly matched the surgeon's findings. Seventy-five patients had successful fistula creation. Sixty-one patients (82%) who had fistulas placed were accurately predicted by their preoperative mapping. Of the 83 patients, 94% presented for a 2-week follow-up appointment. At this point, 81% of fistulas showed evidence of a good thrill and were developing at a sufficient rate. In addition, 89% of these patients presented for a long-term follow-up appointment at 60 days postoperatively. Approximately 6.7% of these patients required additional intervention to progress fistula maturation at this point.
Conclusion
Further prospective studies with additional centers to use as control groups would be helpful in evaluating this technique. However, this scanning protocol shows promise as a method of obtaining favorable results in a consistent fashion.
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