Preoperative computer simulation for planning of vascular access surgery in hemodialysis patients.
Preoperative computer simulation for planning of vascular access surgery in hemodialysis patients.
J Vasc Access. 2017 Mar 06;18(Suppl. 1):118-124
Authors: Zonnebeld N, Huberts W, van Loon MM, Delhaas T, Tordoir JH
Abstract
INTRODUCTION: The arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis patients. Unfortunately, 20-40% of all constructed AVFs fail to mature (FTM), and are therefore not usable for hemodialysis. AVF maturation importantly depends on postoperative blood volume flow. Predicting patient-specific immediate postoperative flow could therefore support surgical planning. A computational model predicting blood volume flow is available, but the effect of blood flow predictions on the clinical endpoint of maturation (at least 500 mL/min blood volume flow, diameter of the venous cannulation segment ≥4 mm) remains undetermined.
METHODS: A multicenter randomized clinical trial will be conducted in which 372 patients will be randomized (1:1 allocation ratio) between conventional healthcare and computational model-aided decision making. All patients are extensively examined using duplex ultrasonography (DUS) during preoperative assessment (12 venous and 11 arterial diameter measurements; 3 arterial volume flow measurements). The computational model will predict patient-specific immediate postoperative blood volume flows based on this DUS examination. Using these predictions, the preferred AVF c...
Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research