Volume 48, Issue 1 March 2024 JVU 481-36 | Arteriovenous Fistula Stenosis: Correlating Degree of Neointimal Hyperplasia w/ Reduction in Volume Flow Measured on Ultrasound & Ultrasound Characterization-Arteriovenous Fistula Stenosis: Correlating Degree of Neointimal Hyperplasia with Reduction in Volume Flow Measured on Ultrasound and Ultrasound Characterization Based in Stenosis Morphology

Arteriovenous Fistula Stenosis: Correlating Degree of Neointimal Hyperplasia with Reduction in Volume Flow Measured on Ultrasound and Ultrasound Characterization Based in Stenosis Morphology

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This research article discusses the use of ultrasound to diagnose and grade arteriovenous fistula (AVF) stenosis, a common complication of vascular access in dialysis patients. The study aimed to examine the incidence and degree of neointimal hyperplasia (IMT) in AVF stenoses and correlate it with volume flow as an indicator of AVF dysfunction. The researchers performed duplex ultrasound examinations on 156 AVF stenoses and measured luminal and vessel wall diameters to calculate the percentage of IMT (%IMT). They found that the mean %IMT was 45% and %IMT had a moderate predictive value in predicting volume flow. They identified four different lesion types based on ultrasound appearances: lesions with no measurable IMT, lesions with predominantly intimal hyperplasia, lesions with nonpredominant intimal hyperplasia, and valve-type stenosis. The researchers concluded that %IMT can be used to characterize AVF stenosis and differentiate between different types of lesions. They suggested that including measurements of %IMT in clinical trials could help improve outcomes for patients and guide treatment decisions. Further research is needed to refine the classification of lesion types and explore their response to different interventions, such as drug-coated balloons.

Keywords

ultrasound

arteriovenous fistula

AVF stenosis

neointimal hyperplasia

volume flow

duplex ultrasound

IMT percentage

intimal hyperplasia

lesion types

clinical trials