In the report of their dedicated surveillance program aimed at optimizing the functional access rate at first dialysis, a functional outcome rate of 94.2% (145/154 patients) at the time of first dialysis or at the end of the studied period was noted. Forty reinterventions were needed secondary to failure to mature in 31 patients (31/40; 77.5%). Thus, an average of 1.29 interventions for every nonmaturing AVF was reported. Reinterventions were required in 9 of 40 (22.5%) of these cases (n = 20) due to dysfunction after there was deemed to be an initial successful maturation. In this cohort, 41.4% of reported reinterventions were required prior to duplex US investigation [101]. Along with flow measurements, direct or derived static pressure, duplex US provides effective surveillance techniques for detection of a nonmaturing AVF in the predialysis stage [102]. Singh et al [103] reported a systematic use of US in triaging immature AVFs and reported an increase in 47% of AVFs that successfully matured to usability by dialysis. CTA Extremity Area of Interest With IV Contrast Contrast-enhanced MDCT angiography may be used to evaluate for anastomotic or juxta-anastomotic strictures, outflow vein stenosis, or dispersal of flow due to an accessory vein in patients with failure of maturation [17,85,104]. CTV Extremity Area of Interest With IV Contrast There is no identified relevant literature to support the use of CTV extremity in evaluating a failure of an AVF to mature. MRA Extremity Area of Interest Without and With IV Contrast There is no identified relevant literature to support the use of MRA extremity without and with IV contrast in evaluating a failure of an AVF to mature. MRA Extremity Area of Interest Without IV Contrast There is no identified relevant literature to support the use of MRA extremity without IV contrast in evaluating a failure of an AVF to mature.
Dialysis Fistula Malfunction. In the report of their dedicated surveillance program aimed at optimizing the functional access rate at first dialysis, a functional outcome rate of 94.2% (145/154 patients) at the time of first dialysis or at the end of the studied period was noted. Forty reinterventions were needed secondary to failure to mature in 31 patients (31/40; 77.5%). Thus, an average of 1.29 interventions for every nonmaturing AVF was reported. Reinterventions were required in 9 of 40 (22.5%) of these cases (n = 20) due to dysfunction after there was deemed to be an initial successful maturation. In this cohort, 41.4% of reported reinterventions were required prior to duplex US investigation [101]. Along with flow measurements, direct or derived static pressure, duplex US provides effective surveillance techniques for detection of a nonmaturing AVF in the predialysis stage [102]. Singh et al [103] reported a systematic use of US in triaging immature AVFs and reported an increase in 47% of AVFs that successfully matured to usability by dialysis. CTA Extremity Area of Interest With IV Contrast Contrast-enhanced MDCT angiography may be used to evaluate for anastomotic or juxta-anastomotic strictures, outflow vein stenosis, or dispersal of flow due to an accessory vein in patients with failure of maturation [17,85,104]. CTV Extremity Area of Interest With IV Contrast There is no identified relevant literature to support the use of CTV extremity in evaluating a failure of an AVF to mature. MRA Extremity Area of Interest Without and With IV Contrast There is no identified relevant literature to support the use of MRA extremity without and with IV contrast in evaluating a failure of an AVF to mature. MRA Extremity Area of Interest Without IV Contrast There is no identified relevant literature to support the use of MRA extremity without IV contrast in evaluating a failure of an AVF to mature.