Main Article Content

Abstract

Introduction: Doppler ultrasound and dilutional methods allow monitoring of vascular access flow. The presence of collateral veins may influence the determination of vascular access flow.
Objective: To determine the influence of collateral veins on the vascular access flow measurement by Doppler ultrasound and by the thermodilution method.


Material and Method: Observational and prospective study. Native arteriovenous fistulas that met the selection criteria were selected. An annual measurement of vascular access flow by Doppler ultrasound and two quarterly thermodilution measurements (thermodilution-1 and thermodilution-2) were performed. Ultrasound was used to determine the presence of collateral veins.
Results: Thirty-eight native arteriovenous fistulae were analysed. Males accounted for 78.9% of the sample. Collateral veins were present in 23.6% of cases. Analysing the whole sample, a linear correlation was obtained between ultrasound-Doppler flows with thermodilution-1 (0.694) and thermodilution-2 (0.678), [both p<0.001]. When stratified by collateral veins, when no collateral veins were present, there was a significant correlation between Doppler ultrasound with thermodilution-1 (0.698) and thermodilution-2 (0.696) [both p<0.001)]; whereas the correlation was non-significant when collateral veins were present.
Conclusions: There is correlation between vascular access flow measurement obtained by Doppler ultrasound and thermodilution; the presence of collateral veins modifies such relationship. It is necessary to implement vascular access surveillance programs that include different monitoring methods in order to mitigate the effect of collateral veins on vascular access flow determination.

Keywords

vascular access vascular access flow (QA) native arteriovenous fistulas doppler ultrasound thermodilution collateral veins

Article Details

How to Cite
1.
Rubio-Castañeda FJ, Fernández-Núñez M, Sierra-Sánchez AI, Cantín-Lahoz V, Ferrer-López E, Mateo-Sánchez MA. Influence of collateral veins on vascular access flow measurement using ultrasound and thermodilution: Observational study. Enferm Nefrol [Internet]. 2022 [cited 2025 Apr 30];25(4):[about 7 p.]. Available from: https://www.enfermerianefrologica.com/revista/article/view/4550

References

  1. Ibeas J, Roca-Tey R , Vallespín J, Moreno T, Moñux G , Martí –Monrós A, et al. Guía clínica española del acceso vascular para hemodiálisis. Nefrología 2017;37:1-177. DOI: https://doi.org/10.1016/j.nefro.2017.11.004
  2. Sánchez Tocino ML, López Gonzalez A, Sánchez Martín A, Villoria-Gonzalez S, Turrión cabezas V, Gascón Colorada M, et al. Efecto de la dirección de la aguja arterial en la medición del flujo del acceso vascular con métodos dilucionales. Enferm Nefrol 2017;20(4):305-15. DOI: https://doi.org/10.4321/S2254-28842017000400004
  3. Fontseré N, Mestres G, Barrufet M, Burrel M, Vera M, Arias M, et al. Aplicación práctica de la termodilución frente a la ecografía_Doppler en la medición del flujo del acceso vascular. Nefrología 2013;33:325-32.
  4. Roca-Tey R, Rivas A, Samon R, Ibrik O, Viladoms J. Study of vascular access (VA) by color Doppler ultrasonography (CDU). Comparison between Delta-H and CDU methods in measuring VA blood flow rate. Nefrologia 2005;25:678-83.
  5. Guedes-Marques M, Ibeas J, Botelho C, Maia P, Ponce P. Doppler ultrasound: a powerful tool for vascular access surveillance. Semin Dial 2015;28:206-10. DOI: https://doi.org/10.1111/sdi.12334
  6. Sacquépée M, Tivollier JM, Doussy Y, Quirin N, Valéry JC, Cantin JF. Comparison of different techniques of hemodialysis vascular access flow evaluation: blood temperature monitoring thermodilution and Doppler debimetry. Nephrol Ther 2012;8:96-100. DOI: https://doi.org/10.1016/j.nephro.2011.09.001
  7. Sánchez Tocino ML, López González A, Villoria González S, González Sánchez MI, García Macías M, González Horna A, et al. Validación del método inverso para la determinación del flujo del acceso con termodiclución. Nefrologia 2022;42(1):56–64. DOI: https://doi.org/10.1016/j.nefro.2021.01.007
  8. Martín Osorio MD, Parada López I, Barquero Ruano RM, Rodríguez Peña MJ, Uguet Canal M, Palacios García G. Medición del flujo del acceso vascular mediante biocontrol de temperatura BTM comparado con técnica de dilución por ultrasonidos. Libro de comunicaciones XXXVI Congreso Nacional SEDEN;2011 Oct 19-22; Sevilla, España; 2011. p. 182-85.
  9. Sánchez-Tocino ML, López-González A, Villoria-González S, González-Sánchez, Puente.González AS. Variabilidad intramétodo en medidas del flujo del acceso vascular con termodilución: ¿Un enemigo en los programas de seguimiento?. Enferm Nefrol 2020;23(4):353-60. DOI: https://doi.org/10.37551/S2254-28842020036
  10. Schneditz D, Wang E, Levin NW. Validation of haemodialysis recirculation and access blood flow measured by thermodilution. Neprhrol Dial Transplant 1999;14:376-83. DOI: https://doi.org/10.1093/ndt/14.2.376
  11. Gómez Coca S, Ortiz Fernández S, Villamor Ruiz, E. M. (2018). Técnica de punción idónea de la fistula arteriovenosa según la evidencia científica. Trances 2018;10(2):187-98.
  12. Ibeas J, Iglesias R, Merino J, Rubiella C, Vallespin J, Vinuesa X. Manual de ecografía para la exploración del acceso vascular. 1ª ed. Iglesias R, Ibeas J, vallespin J, editor. Madrid (España): EDTNA/ERCA;2019.
  13. Aragoncillo I. Ecografía Doppler en el acceso vascular. Nefrología al día [Internet]. 2021 [consultado 29 Jun 2022].Disponible en: https://www.nefrologiaaldia.org/291.
  14. Muchayi T, Salman L, Tamariz LJ, Asif A, Rizvi A, Lenz O, et al. A meta-analysis of randomized clinical trials assessing hemodialysis access thrombosis based on access flow monitoring: where do we stand?. Semin Dial 2015;28(2):23-9. DOI: https://doi.org/10.1111/sdi.12342
  15. Sheth R, Freed R, Tavri S, Huynh T, Irani Z. Nonmaturing Fistulae: Epidemiology, Possible Interventions, and outcomes. Tech Vasc Interv Radiol 2017;20(1):31-7. DOI: https://doi.org/10.1053/j.tvir.2016.11.004
  16. Vascular Access 2006 Work Group (NFK/DOQI). Clinical practice guidelines for vascular access. Am J Kidney Dis 2006;48 (Suppl 1):S176-247. DOI: https://doi.org/10.1053/j.ajkd.2006.04.029
  17. Caro P, Delgado R, Dapena F, Aguilera A. La utilidad de la presión intra-acces. Nefrología 2004;24:357-63.

Most read articles by the same author(s)

Similar Articles

<< < 15 

You may also start an advanced similarity search for this article.