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Safety of Brachial Arteriogram using a 3-French Dilator to Evaluate Nonmaturing Arteriovenous Fistulae

Authors

  • Tushar J. Vachharajani,

    Corresponding author
    1. Department of Nephrology, W. G. (Bill) Hefner Veterans Affairs Medical Center, Salisbury, North Carolina
    • Address correspondence to: Tushar J. Vachharajani, M.D., Chief, Nephrology Section, W. G. (Bill) Hefner VA Medical Center, Salisbury, NC 28144, Tel.: +1-704-638-9000, Fax: +1-704-638-3855, or e-mail: tushar.vachhrajani@va.gov.

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  • Arif Asif

    1. Department of Nephrology, Albany Medical College, Albany, New York
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Abstract

Nonmaturing arteriovenous fistula remains a hurdle in improving the fistula rate in the hemodialysis population. Timely referral can assist in salvaging fistula with endovascular interventions. Pathology at the inflow segment is frequently encountered as a primary reason for maturation failure. Conventional retrograde angiography can result in poor delineation of the inflow segment and may not be an ideal method for evaluating nonmaturing fistulae. Moreover, the risk of vascular rupture and overzealous diagnosis of accessory veins often result in additional unnecessary therapeutic interventions. Alternatively, a direct brachial arteriogram can provide complete anatomic delineation to perform appropriate endovascular interventions.

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