PREDICTIVE VALUE OF COLOR DOPPLER ULTRASONOGRAPHY IN DETECTING FAILURE OF VASCULAR ACCESS GRAFTS

The predictive role of colour Doppler ultrasonography in determining t he initial success and long-term patency of polytetrafluoroethylene (P TFE) vascular access grafts for haemodialysis was investigated. Two gr oups of patients were studied. The upper extremities of 21 patients in the control group were assessed by clinical examination only; those o f 17 in a second group (Doppler group) were also assessed by ultrasono graphy before and after operation. Straight PTFE vascular access graft s were used between the brachial artery and axillary vein in all patie nts. The median preoperative brachial artery flow rate was significant ly lower in patients who later developed graft thrombosis (66 versus 8 7 ml/min, P<0.01), as was the median postoperative graft flow rate (48 0 versus 800 ml/min, P<0.001). Routine preoperative and postoperative colour Doppler ultrasonography is recommended for every patient in who m a vascular access graft is planned.