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Value of duplex Doppler ultrasonography for the evaluation of dysfunctional hemodialysis access arteriovenous fistulas prior to endovascular interventions
Author(s) -
Conkbayir Isik,
Celtikci Pinar,
Ergun Onur,
Durmaz Hasan Ali
Publication year - 2018
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.22601
Subject(s) - medicine , radiology , digital subtraction angiography , hemodialysis access , duplex ultrasonography , predictive value , duplex (building) , arteriovenous fistula , predictive value of tests , angiography , hemodialysis , nuclear medicine , ultrasonography , surgery , vascular access , dna , genetics , biology
Purpose To demonstrate accuracy of duplex Doppler ultrasonography (DUS) for the evaluation of native‐vein arteriovenous fistula (AVF) dysfunction in end‐stage renal disease patients. Methods This retrospective study included 60 patients with dysfunctioning native‐vein AVF evaluated with DUS and digital subtraction angiography (DSA) whose results were compared for detection, identification, and localization of AVF lesions. We calculated sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of DUS and evaluated the agreement between DUS and DSA by the Cohen's kappa coefficient (κ). Results DUS identified correctly 123 of 130 lesions (sensitivity 94.6%, specificity 97.5%, PPV 98.4%, NPV 92%, accuracy of 95.7%). DUS localized correctly 123 of 130 lesions (sensitivity 94.6%, specificity 98.4%, PPV 98.4%, NPV 94.6%, accuracy 96.4%). The κ value was 0.9120 for detection of all lesions (almost perfect agreement). Conclusion DUS is a reliable method for the initial evaluation of dysfunctional AVFs, with high sensitivity for detecting and correctly localizing circuit problems.