Author/Editor		Buturović-Ponikvar, Jadranka
Title		Ultrasonography for vascular access
Type		članek
Source		In: Mešić E, editor. Zbornik radova 2. nefrološkog kongresa Bosne i Hercegovine; 2005 apr 6-9; Tuzla. Tuzla: Print Com,
Publication year		2005
Volume		str. 21-5
Language		eng
Abstract		Ultrasonography has an increasing role in vascular access for hemodialysis. When hemodialysis catheters are concerned, ultrasonograhy can be used before classical landmark insertion to assess the anatomy of especially jugular veins (that is atypical in up to 25% of cases), such avoiding unnecessary punction. The better option is to insert hemodialysis catheters under realtime ultrasound guidance, either with a free-hand technique or with needle-guide. Such insertion reduces the number of punctures, enables the pucturing of targeted vein with one puncture in the majority of patients and safer and easier catheter insertion for less experienced physician. It should be standard for at least jugular vein insertion. The possible long-term benefit should be explored. As arteriovenous fistula and grafts are concerned, the role of ultrasonography can be divided into three parts: a) preoperative mapping aimed to explore patients' arteries and veins of both arms and suggest the type and best position of arteriovenous fistula construction b) to examine functioning arteriovenous fistula and graft with clinical problem c) to assess suddenly thrombosed arteriovenous fistula or graft and suggest the best salvage procedure. Today angiography of vascular access should be reserved for imaging of central veins and interventional procedures.
Descriptors		HEMODIALYSIS ARTERIOVENOUS SHUNT, SURGICAL CATHETERS, INDWELLING JUGULAR VEINS