European Journal of Cardiovascular Medicine

Introduction: End-stage renal disease (ESRD) patients who need long-term hemodialysis often have dialysis fistulas created. Due to their long-term patency, high flow rates, and ability to be cannulated repeatedly, arteriovenous fistulas (AVFs) are the preferred access method. AVF creation connects an arm artery and vein to increase blood pressure and flow to the vein, which widens for hemodialysis. DUS (Doppler ultrasound) is the only diagnostic imaging method that simultaneously displays an area's anatomy (B-mode imaging) and blood supply (Color and Doppler imaging). Material and methods: The study was conducted on 40 patients at a department of surgery in central India from January to December 2022. Patients were divided into two groups: one with preoperative color doppler and the other based on clinical findings alone. Measurements were taken using the Aloka Prosound α-10 duplex machine, with the cephalic vein and brachial and radial arteries being measured. Result: 19 males and 21 females in Group A and 56.1 in Group B were enrolled. The study compared vascular access surgery patients with and without preoperative Doppler ultrasound scans. Age, sex, smoking status, and residence did not differ between groups. Vascular access was significantly different between the two groups. Group A had 75% left upper limb VA and 25% contralateral VA, while Group B had 65% left upper limb VA and 35% contralateral VA. Both groups had mostly urban non-smokers. Both groups had the most comorbidities: hypertension and hypercholesterolemia. Preoperative Doppler ultrasound scans improved vascular access surgery vessel selection. DUS and surgery showed significant differences in artery and vein diameter. DUS and clinical evaluations yielded 14 and 11 mature AVF, respectively. 12 DUS-functional and 8 clinical-functional. Statistical difference. DM and HTN comorbidities increased failure rate. Conclusion: The study analyzed the impact of preoperative duplex mapping for arterial and venous system and found that it reduces the failure rates in AV access surgery. The study compared the outcomes of AV access surgery based on clinical versus duplex method and found that the duplex method had a lower failure rate. The causes of early failure rates were also examined. The study identified the risk group that requires definite preoperative duplex mapping, which includes patients over 50 years old, female patients, and patients with comorbidities. However, the measurement by duplex scan is subject to operator-dependent errors.