Role of Doppler Ultrasonography in Planning, Maturation and Complication Assessment of Arteriovenous Fistula

AIM: 1. To Study the role of Colour Doppler Ultrasound in Preoperative Planning , maturity Assessment and Complication Detection of Arteriovenous fistula in cases of Haemodialysis in End Stage Renal disease(ESRD) OBJECTIVES: Correlate preoperative CDU measurements (vessel diameters, depths, flow characteristics) with intra operative surgical finding store fine vessel selection criteria. Assessearly postoperative CDU flow parameters (7–14 days post-creation) as predictors of AVF maturation or failure. Determine primary patency rates at 4-6weeks and examine associations with comorbidities prevalent in Indian patients (diabetes, hypertension, dyslipidaemia). Document post operative complications and failure rates. MATERIAL AND METHODS: This study is a prospective observational study conducted at Gandhi Medical College and Hospital, Secunderabad, Telangana, a tertiary care referral center in South India, in the department of Radiodiagnosis. The study was approved by the Institutional Ethics Committee (IEC). The sample size was 50. All participants were enrolled after obtaining written in formed consent in their native language. Confidentiality of patient identity and clinical records was strictly maintained. The study complied with the ethical standards outlined in the ICMR Guidelines for Biomedical Research on Human Participants. All patients diagnosed as ESRD and requiring a haemodialysis for the first time, patient swhohadmal function ing AVF and required new creation of fistula at the other limb, patients who consented to follow-uppost-operative and for dialysis sessions and patients having temporary catheter for dialysis were included in the study. Those who had previous fistula formation in the same upper limb , patients with poor vascularity (such as obvious vessel wall calcification and small calibre), or anyfistulafailurewithin1week (consideredas surgical failure) , and patients with upper limbarterial diseases like Raynaud’s disease were excluded. PRE OPERATIVE DOPPLER EVALUATION: Each patient underwent comprehensive preoperative Doppler evaluation of the upper limb (typically non-dominant) before surgery to select patients deemed suitable for radio cephalic arteriovenous fistula creation.