Role of Preoperative Vascular Ultrasonography in Hemodialysis Vascular Access Operation
Boonying Siribumrungwong MD*, Prakitpunthu Tomtitchong MD, PhD*, Kitti Kanpirom MD, FACS**
Affiliation : * Department of Surgery, Thammasat University Hospital, Thammasat University Rangsit Campus, Pathumtani, Thailand **Office of Permanent Secretary, Ministry of Public Health, Nonthaburi, Thailand
Objective : Preoperative vascular mapping increase rate of successful hemodialysis vascular access operation. Several
studies recommend using this procedure routinely. But some studies recommend using this procedure in selected patients. So
this study aims to determine the impacts of preoperative vascular mapping in unfavorable-examined patients.
Material and Method: 55 patients were studied retrospectively from August 2006 to October 2009. Before April 2008, the
operative plans were based on physical examination (group 1). After April 2008, the surgeon did preoperative vascular
mapping prior to the operation in unfavorable-examined patients (group 2). The results were compared.
Results : There were high maturation rates in favorable-examined patients. In unfavorable-examined patients, preoperative
vascular mapping can identified nonpalpable favorable vein which successful maturation of 18.75%. Complementary duplex
scan decrease rate of unsuccessful operation significantly (p = 0.037) but does not increase maturation rate.
Conclusion : Careful physical examination is important part before operation. Preoperative vascular mapping has benefit
only in patients with unfavorable-examined patients. It finds some nonpalpable favorable vein and decrease unsuccessful
exploration.
Keywords : Vascular mapping, Arteriovenous fistula, Dialysis, Vascular access, Duplex
