Ultrasonographic Assessment of Polytetrafluoroethylene Upper Extremity Arteriovenous Hemodialysis Access: A Retrospective Analysis of 31 Cases

Polytetrafluoroethylene (PTFE) vascular grafts are used for hemodialysis vascular access. Because their longevity is less than that of autologous fistulae, close surveillance is necessary to reduce the incidence of complications. The purpose of this study was to evaluate the usefulness of Doppler sonography for the surveillance of PTFE graft hemodialysis access. Thirty‐one patients with renal failure who had dialysis access created with a PTFE graft were included in this study. The patient records along with ultrasonography were retrospectively reviewed. Two‐dimensional ultrasonography clearly revealed the U‐shape of the subcutaneous PTFE graft, and autologous artery and superficial vein connecting with the graft. There was no ultrasound echo inside the graft, but the wall was a continuous line‐like hyperechoic structure. Blood flow in the graft and hemodynamic parameters could be determined with color Doppler ultrasonography. Ultrasound examination diagnosed graft thromboses in six patients, pseudoaneurysm in two, seroma in one, and subcutaneous edema in three patients. Ultrasonography is useful for the monitoring and diagnosis of complications of PTFE dialysis access grafts.