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논문분류	춘계학술대회 초록집
제목	Ultrasound Guided Endo-vascular Procedures - "Revisiting an Old Friend" - Experience from a Tertiary Care Center in South India
저자	ATHISH M N
출판정보	2024; 2024(1):
키워드
초록	Objectives: To evaluate the feasibility of USG guided AV access salvage and to determine the technical and clinical success rates To evlaute the patency rates at 6 months Methods: We reviewed 70 cases of USG guided PTA which were done at our institute between September 2022 and August 2023 All cases except for central vein stenosis were included. Technical and clinical success were defined as successfull completion of the procedure and ability to dialyse the patient with 250 ml/minute flows respectively. All cases underwent an immediate doppler where diameters and flows were checked and were followed up at 3 and 6 months with a measure of flows and vessel diameter Results: Technical and clinical success- acheived in 84% cases , but by 6 months, patency rates were 70%. Procedure had failed in patients with long standing thrombus, large thrombus burden and tight stenotic lesions which recoiled immediate post procedure. Complications included minor venous tears(10%) - conservatively managed and bleeding diathesis post thrombolysis, arterial rupture and pain at the procedure site. Mean time to completion was initially 4 hours, but currently stands at 2 hours, probably because of better anatomy identification on USG. Diabetes and diabetic kidney disease were the main causes for RRT initiaiton and access dysfunction, proabably related to the vascular complications of diabetes. It is notable to see that at the end of 6 months, 42/70 patients still had a well functioning AV fistula, thereby mitigating the cost of an alternate access creation. Conclusions: This is, to the best of our knowledge, the first study of USG guided endovascular procedure with a six month follow up of patients in South East Asia. We have found that it is an effective and safer alternative for access salvage, with no radiation exposure. However, it needs skill, patience & a dedicated team for tangible results
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