Preoperative Ultrasound Assessment for Dialysis Access Placement

Abstract

Vascular access includes any form of cannulation of arteries or veins. For the treatment of chronic renal failure, this term refers to the ability to access both the arterial inflow and the venous outflow for the purpose of replacing the function of the kidney. This work provides a brief review of the history of hemodialysis and presents the method we use currently to map the arterial and venous system prior to placement of an arteriovenous fistula. The purpose is to present the process we use to determine the status of the arteries and the venous patency, as well as the flow diagram we use to determine the steps taken for each patient referred for preoperative vein mapping, including the worksheet used to collect the information for the surgeon. This work presents the minimum prerequisites that are thought to be necessary to create a viable arteriovenous fistula. A brief discussion of the criteria and protocol is presented that is used to diagnose steal syndrome from the hand. Billing codes are included when this procedure is used.