What is the purpose of referring a new patient to the surgeon for “AVF only” – and what is the role of vessel mapping?
Such a referral ensures that a surgeon will initially evaluate the patient for an AV fistula. It also serves to focus everyone’s attention on the goal of providing the patient with the best chance of having an autogenous (native) AV fistula before considering an AV graft or catheter for maintenance hemodialysis. If the surgeon cannot find suitable blood vessels for an AV fistula on physical exam with a tourniquet, Doppler ultrasound or alternate technique should be used to do vessel mapping (identification of vessel anatomy) to search for suitable vessels that may be too deep to be identified on physical exam. Numerous studies have shown that vessel mapping identifies vessels suitable for an AV fistula in the majority of patients where physical exam alone classified the patient as not being a candidate for an AV fistula. See the following related information: Early Referral to Surgeon for “AVF Only” Evaluation and Timely Placement Q: When an artery is scanned as a part of preop vessel
Such a referral ensures that a surgeon will initially evaluate the patient for an AV fistula. It also serves to focus everyone’s attention on the goal of providing the patient with the best chance of having an autogenous (native) AV fistula before considering an AV graft or catheter for maintenance hemodialysis. If the surgeon cannot find suitable blood vessels for an AV fistula on physical exam with a tourniquet, Doppler ultrasound or alternate technique should be used to do vessel mapping (identification of vessel anatomy) to search for suitable vessels that may be too deep to be identified on physical exam. Numerous studies have shown that vessel mapping identifies vessels suitable for an AV fistula in the majority of patients where physical exam alone classified the patient as not being a candidate for an AV fistula.
