Color flow and image-directed Doppler ultrasound evaluation of iatrogenic arteriovenous fistulas in the groin

✍ Scribed by Marilyn A. Roubidoux; Barbara S. Hertzberg; Barbara A. Carroll; Carolyn A. Hedgepeth

• Publisher: John Wiley and Sons
• Year: 1990
• Tongue: English
• Weight: 760 KB
• Volume: 18
• Category: Article
• ISSN: 0091-2751
• DOI: 10.1002/jcu.1870180603

✦ Synopsis

Color flow image-directed Doppler ultrasound was used to image 9 iatrogenic arteriovenous (AV) fistulas in the groin following femoral artery catheterization. Characteristic findings in the color images and spectral waveforms seen in most patients included visible connection between the artery and vein (8 cases); (2) a multicolored speckled mass at the fistula site (7 cases); (3) spreading of color pixels into the extraluminal soft tissues (7 cases); (4) high diastolic flow in the arterial waveform proximal to the fistula site (7 cases); (5) decreased flow in the artery caudal to the fistula (5 cases); and (6) high velocity turbulent flow, sometimes with a pulsatile component, in the vein near the fistula (9 cases). The authors conclude that color flow imaging is useful in differentiating an AV fistula from other complications of femoral artery catheterization, such as pseudoaneurysm or hematoma. Indexing Words: Fistula, arteriovenous * Arteries, Doppler

Color Doppler

Femoral artery catheterization has become increasingly more common due to the widespread use of cardiac catheterization, triple lumen indwelling catheters, and diagnostic and invasive radiologic procedures using the groin as access.1'2 Although vascular complications, such as arteriovenous (AV) fistulas and pseudoaneurysms, are uncommon, they must be accurately diagnosed inasmuch as surgical repair may be Before the advent of image-directed Doppler ultrasound and color flow imaging, these diagnoses depended largely on clinical and angiographic evaluation. More recently, the use of noninvasive techniques, such as color flow and image-directed Doppler imaging, has been described in the evaluation of femoral artery pseudoaneurysms and iatrogenic AV fistula^.^-^

We have also applied these techniques in the diagnosis of peripheral AV fistulas and have observed several characteristic features associated with such fistulas. This article discusses the