Vascular ultrasound for the pre-operative evaluation prior to arteriovenous fistula formation for haemodialysis: review of the evidence

The arteriovenous fistula (AVF) is the preferred access for haemodialysis [1]. However, AVF failure has become more common over the last three decades as more patients are older, and have diabetes or vascular disease. For radiocephalic AVF, a meta-analysis estimated modest primary (63%) and secondary (66%) patencies at 1 year [2]. AVF failures have been attributed to inadequate vessels used for surgery [3]. Pre-operative evaluation with ultrasound may select suitable vessels and reduce AVF failures [3]. We review the evidence for ultrasound evaluation for AVF formation. The following areas are addressed: • Ultrasound criteria for pre-operative evaluation • Pre-operative ultrasound findings and AVF outcomes • Comparison of pre-operative physical examination and ultrasound in terms of AVF outcomes.