DUPLEX SCANNING OF EXPANDED POLYTETRAFLUOROETHYLENE DIALYSIS SHUNTS -IMPACT ON PATIENT-MANAGEMENT AND GRAFT-SURVIVAL

The steady decline with time in patency of expanded polytetrafluoroeth ylene (e-PTFE) dialysis shunts led to a trial protocol of postimplanta tion surveillance to identify those grafts at risk for thrombosis. Dup lex scanning is a noninvasive, reproducible method of monitoring anato mic and hemodynamic aspects of graft function that provides the surgeo n with an opportunity for early operative intervention. The data from this randomized prospective study suggest that early intervention base d on surveillance findings is more successful in terms of access site salvage and morbidity reduction than intervention prompted by graft th rombosis or malfunction is. Duplex scanning appears to be the preferre d modality that, together with timely reoperation, impacts favorably o n functional graft survival.