TY - JOUR T1 - Utility of doppler ultrasound in the preoperative evaluation of the first vascular access for hemodialysis JO - Nefrología (English Edition) T2 - AU - Mateos Torres,Eduardo AU - Collado Nieto,Silvia AU - Cao Baduell,Higini AU - Lacambra Peñart,Mónica AU - Velescu,Alina AU - Clará Velasco,Albert SN - 20132514 M3 - 10.1016/j.nefroe.2019.10.008 DO - 10.1016/j.nefroe.2019.10.008 UR - https://www.revistanefrologia.com/en-utility-doppler-ultrasound-in-preoperative-articulo-S201325141930149X AB - IntroductionTraditionally, the indication of the type of vascular access (VA) has been based on the surgeon's physical examination, but it is now suggested that imaging methods could provide a clinical benefit. Our aim was to determine whether or not preoperative Doppler ultrasound modifies outcomes of the first VA for hemodialysis. Patients and methodsProspective cohort of patients undergoing a first VA from June 2014 to July 2017 who had a preoperative Doppler ultrasound (ECO group). They were compared to a historical cohort (January 2012–May 2014) of first VA indicated exclusively by clinical assessment (CLN group). ResultsA total of 86 patients from the CLN group were compared to 92 from the ECO group, which was younger (68.4 vs 64.0, p=0.038).The primary patency (CLN/ECO) at 1 and 2 years was 59.5%/71.9% and 53.1%/57.8% respectively, marginally better in the ECO group (p=0.057). The assisted patency at 1 and 2 years was 63.2%/80.7% and 58.1%/70.2%, respectively, significantly better for the ECO group (p=0.010).Due to lack of patency/utility of the initial VA, 26.7% in the CLN group and 7.6% in the ECO group (p<0.001) required a new VA during the first 6 months. An average of 1.39 interventions were performed to achieve a useful VA in the CLN group and 1.08 in the ECO group (p<0.001), the first VA being useful at the radiocephalic level in 31.0%/45.1% (p=0.039). ConclusionThe indication of the first VA according to a preoperative Doppler ultrasound examination could decrease the need for new VA, enable them to be made more distal, and significantly improve patency. ER -