{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T04:25:24Z","timestamp":1696047924217},"reference-count":31,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,10,23]],"date-time":"2014-10-23T00:00:00Z","timestamp":1414022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Seminars in Dialysis"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Hemodialysis vascular access surveillance for hemodynamically significant stenosis can be a challenge because no universal gold standard exists. The StenTec Gauge measures static intra\u2010access peak pressure and graphically displays the ratio of this pressure to systemic systolic (peak) arterial pressure (<jats:styled-content style=\"fixed-case\">P<jats:sub>IA<\/jats:sub><\/jats:styled-content> ratio). In combination with careful physical exam (<jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content>), the StenTec Gauge is an acceptable and cost\u2010effective way of detecting hemodynamically significant stenosis in arteriovenous fistulas (<jats:styled-content style=\"fixed-case\">AVF<\/jats:styled-content>) or grafts (<jats:styled-content style=\"fixed-case\">AVG<\/jats:styled-content>). In a selected population of 21 hemodialysis patients with mature arteriovenous access, a StenTec reading and physical examination was measured on a weekly basis. Interventional procedures for suspected access dysfunction were performed if there was a greater than 25% increase of the <jats:styled-content style=\"fixed-case\">P<jats:sub>IA<\/jats:sub><\/jats:styled-content> ratio from baseline in two consecutive readings, along with correlating clinical suspicion from physical examination findings. StenTec independently had a sensitivity of 56% and a specificity of 99% in detecting clinically significant stenosis. <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content> alone had a sensitivity of 89% and a specificity of 100%. StenTec combined with <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content> had a sensitivity of 100% and a specificity of 99% for predicting hemodynamically significant stenosis. StenTec detected 4 of 10 patients who had a <jats:styled-content style=\"fixed-case\">P<jats:sub>IA<\/jats:sub><\/jats:styled-content> ratio value of \u22650.5, which correlates with current National Kidney Foundation Disease Outcomes Quality Initiative (<jats:styled-content style=\"fixed-case\">KDOQI<\/jats:styled-content>) criteria for mean intra\u2010access pressure ratios indicating a clinically significant outflow stenosis. <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content> predicted 9 of 10 patients with stenosis, and the combination of StenTec and <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content> predicted all 10 patients with clinically significant stenosis using the <jats:styled-content style=\"fixed-case\">KDOQI<\/jats:styled-content> criteria for P<jats:sub>IA<\/jats:sub> ratio. Hemodynamically significant access stenosis can be detected with excellent accuracy using both StenTec and <jats:styled-content style=\"fixed-case\">PE<\/jats:styled-content> measurements combined for monitoring and surveillance methods.<\/jats:p>","DOI":"10.1111\/sdi.12311","type":"journal-article","created":{"date-parts":[[2014,10,24]],"date-time":"2014-10-24T03:35:31Z","timestamp":1414121731000},"page":"299-304","source":"Crossref","is-referenced-by-count":1,"title":["Monitoring and Surveillance of Hemodialysis Vascular Access Using StenTec and Physical Exam"],"prefix":"10.1111","volume":"28","author":[{"given":"Rajiv","family":"Dhamija","sequence":"first","affiliation":[{"name":"Rancho Los Amigos National Rehabilitation Center Downey California"},{"name":"Western University of Health Sciences Pomona California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shawn K.","family":"Nash","sequence":"additional","affiliation":[{"name":"Rancho Los Amigos National Rehabilitation Center Downey California"},{"name":"Western University of Health Sciences Pomona California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shawn V.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Rancho Los Amigos National Rehabilitation Center Downey California"},{"name":"Western University of Health Sciences Pomona California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyle","family":"Slack","sequence":"additional","affiliation":[{"name":"Rancho Los Amigos National Rehabilitation Center Downey California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Tadeo","sequence":"additional","affiliation":[{"name":"Rancho Los Amigos National Rehabilitation Center Downey California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,10,23]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2009.10.021"},{"key":"e_1_2_6_3_1","first-page":"30","article-title":"How data can help reduce vascular access events","volume":"26","author":"Swails\u2010Climer M","year":"2012","journal-title":"Nephrol News Issues"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/15.11.1755"},{"key":"e_1_2_6_5_1","first-page":"344","article-title":"Comparison of procedure cost for thrombectomy of arteriovenous fistulas and grafts","volume":"10","author":"Schon D","year":"2012","journal-title":"Semin Dial"},{"key":"e_1_2_6_6_1","volume-title":"Total Medicare Expenditures for Vascular Access by Access Type","author":"Eggers P","year":"2005"},{"key":"e_1_2_6_7_1","volume-title":"Interventional Nephrology","author":"Asif A","year":"2012"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2001.24526"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-139X.2012.01094.x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.00860207"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1755.2004.00946.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1681\/ASN.V92284","article-title":"Simplified measurement of intra\u2010access pressure","volume":"2","author":"Besarab A","year":"1998","journal-title":"Clin J Am Soc Nephrol"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.06220710"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1797.2008.00992.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfn275"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1159\/000082010"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1995.192"},{"key":"e_1_2_6_18_1","first-page":"1117","article-title":"Hemodialysis access dysfunction: a cellular and molecular viewpoint","volume":"17","author":"Roy\u2010Chaudury P","year":"2006","journal-title":"Clin J Am Soc Nephrol"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2011.337"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-139X.2011.01037.x"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-139X.2007.00382.x"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-139X.2007.00419.x"},{"key":"e_1_2_6_23_1","unstructured":"BeathardGA:A practitioner's resource guide to physical examination of dialysis vascular access. 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