Author/Editor		Urbančič, Alenka; Ponikvar, Rafael; Klančar, Janko
Title		Successful intervention in PTFE graft thrombosis: a role of colour-Doppler ultrasound - a case report
Type		članek
Source		In: Buturović-Ponikvar J, Bren AF, editors. Zbornik 2. slovenski nefrološki kongres z mednarodno udeležbo ob 30. letnici dialize in transplantacije ledvic v Sloveniji; 2000 sep 27-30; Brdo pri Kranju. Ljubljana: Klinični center, Klinični oddelek za nefrologijo,
Publication year		2000
Volume		str. 205-9
Language		eng
Abstract		Colour - flow Doppler Ultrasound (CDU) is a noninvasive method for evaluating hemodialysis accesses. It is useful for identifying these at increased risk for thrombosis and allows prior intervention, prolonging access longevity and its function. In a 61 year old woman on chronic hemodialysis, with a very problematic vessels and many failed vascular accesses in the past, PTFE graft on a right leg failed. CDU (Acuson 128XP/10, 5 MHz linear probe) was performed and thrombus formation in the lumen of the PTFE graft loop was detected. Surgical thrombectomy was performed and Fogarty catheter was used for thrombus elimination from the lumen of the graft and its function was restored. After two days arterial part of the graft was successfully used, but in the venous part high pressure was observed during dialysis. CDU suggested partial thrombosis in the venous part of the graft. Fistulography showed intact venous - graft anastomosis but complete stop of blood flow 15 cm proximal in the vein. Patient was put on heparin. After 5 days retrograde flebography showed along stenotic part of iliac vein with very rough and altered vessel wall surface. Two stents were put in a vessel and good venous blood flow was obtained, providing a good function of PTFE graft. CDU was an accurate source of information for planning the interventions in that case. Data about blood flow characteristics in the PTFE grafts provided by CDU can be an important part of diagnostic and therapeutic efforts of nephrologists to main tain function of vascular accesses and to improve patients' outcome on chronic hemodialysis treatment.
Descriptors		HEMODIALYSIS THROMBOEMBOLISM CATHETERS, INDWELLING MIDDLE AGE ULTRASONOGRAPHY, DOPPLER, COLOR