Dialysis patients have their blood filtered by a machine as their kidneys no longer work. To get blood in and out of these patients it is possible to perform a surgical procedure to increase to size and durability of a vein in the arm to allow repeated needle insertion. This enlarged vein is called a fistula. There is some evidence that ultrasound scanning the blood vessels in the arm before surgery can improve the chances of a successful procedure. The investigators aim to test whether scanning all patients is better than scanning only those who are difficult to assess by physical examination alone.
We will recruit all patients undergoing primary vascular access procedures in our unit who meet inclusion criteria. They will be randomised to either surgery based on clinical findings with duplex ultrasound only if requested by surgeon, or routine duplex ultrasound prior to surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
98
Ultrasound mapping of all blood vessels in the upper limb of interest
Hull Royal Infirmary
Hull, United Kingdom
Primary failure of access (immediate/early thrombosis or failure to mature).
Time frame: 30 days
Assisted primary patency - being the interval from placement until the time of measurement of patency, including intervening manipulations
Time frame: open ended
Secondary patency - The interval from placement until time of patency measurement including intervening manipulations
Time frame: open ended
Site of fistula created
Time frame: within 1 month of recruitment
Functional primary patency - being the interval from the time of access placement until any intervention designed to maintain or re-establish patency or the time of measurement of patency during which the AVF provides dialysis access.
Time frame: open ended
Surgeon grade
Time frame: open ended
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