Duplex ultrasound scanning of the autogenous arterio venous hemodialysis fistula: a vascular surgeon's perspective

Introduction Duplex ultrasound has become the first line of investigation for the autogenous arterio-venous hemodialysis fistula (aAVF). In recent work published by our group, we showed that duplex ultrasound was as accurate as fistulography in the assessment of fistula stenoses. The emergence of duplex ultrasound as the primary tool for examination of the aAVF is the result of better technology, and a better understanding of the anatomy, physiology and pathology of the native fistula circuit. This article addresses the assessment of the aAVF circuit (native fistula). It is universally accepted that the native fistula is greatly superior to the fistula graft2,3,4, and construction of a native fistula should be achievable in up to 90% of patients.