Role of Color Doppler Ultrasonography in the Assessment of Suspected Complicated Brachiocephalic Fistulas in Hemodialysis Patients

Background: Arteriovenous fistula (AVF) has been the preferred vascular access ‌in hemodialysis. Doppler ultrasonography is the main imaging modality of ‌hemodialysis arterio-venous (AV fistula). ‌Aim: to study the role of Color Doppler Ultrasonography (CDUS) in assessment ‌of suspected complication of brachiocephalic fistulas in hemodialysis patients. ‌Patients and methods: Prospective cross-sectional study carried out in the ‌Radiology Department at Al-Imamain Al-Kadhimain Medical city, between ‌November 2021 and November 2022. The study included 50 patients with end ‌stage kidney disease and had suspected non-functioning brachiocephalic fistula. ‌All patients were examined by using linear probe and occasionally curvilinear ‌probe. Color Doppler was done for assessment of associated brachiocephalic ‌arteriovenous fistula (BCAVF) complications. Doppler parameters in the arterial ‌and venous side, blood volume through the fistula, and the type of complication.‌Results: the mean age of the patients was 43.8±12.2 with an age range of (27-68) ‌The fistula was functioning among 12 (24%) patients, functioning with ‌complication among 11 (22%) patients, and not functioning among 27 (54%) ‌patients. Regarding patients with adequate flow and associated complications 5 ‌‌(45.5%) had stenosis, and 6 (54.5%) had aneurysm in comparison of those with ‌fistula dysfunction where thrombosis is shown in 12 (44.44%), stenosis in 10 ‌‌(37.04%), aneurysm in 2 (7.41%) and steal syndrome in 3 (11.11%). ‌Conclusions: CDUS is a good modality for evaluation of quantity and quality of ‌the AVF and detection of early and late complications. Stenosis and thrombosis ‌were the most common complications.‌Key words: Ultrasonography, Brachiocephalic Fistulas, Hemodialysis.‌