Bill Peckmans answer no 2

Our article : “The Application of High Frequency Ultrasound To Assess Arteriovenous Hemodialysis Fistula Vein Wall Morphology For Cannulation Readiness” will be published soon in the Journal " Radiology ".

We evaluated longitudinally the intima- media wall thickness of newly created fistula with an experimental high definition ultrasound over a period of 6 months. All fistula were cannulated when DOQI parameters were reached and with the help of bedside ultrasound for guided needle insertion to ensure placement of needle in the center of the vessel lumen and to verify that there wasn’t backwalling during insertion. We used 17g angiocaths for hemodialysis for all first cannulations. Some fistula blew inmediately after needle entry other within an hour or two of hemodialysis and without patient movement. All infiltration events showed that the cannula was in situ in the vessel lumen and that there had been a leak of blood from the vessel into the tissue around the needle enry to the vessel point.

We found that all fistula that did not blow had an Intima Media Thickness IMT measurement > than 0.13 mm , and we concluded that the evaluation of fistula wall thickness gives an added quantitative AVF vessel wall parameter that predicts cannulation readiness.

Dr. Ballyk is one of the Investigators in our group.

Hope this helps.

Take care and hope to see you soon.

Rosa M. Marticorena R.N.