{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,3,2]],"date-time":"2025-03-02T01:40:06Z","timestamp":1740879606543,"version":"3.38.0"},"reference-count":7,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2017,5,5]],"date-time":"2017-05-05T00:00:00Z","timestamp":1493942400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p> Perioperative ultrasound performed by the operative surgeon can improve outcomes of vascular access surgery. We present the case of a patient referred for dysfunctional vascular access with two separate and patent right arm arteriovenous fistulas (AVF). Pre-operative ultrasound vessel mapping defined the complex anatomy and intraoperative ultrasound allowed the optimal surgical approach for access salvage while avoiding the need for catheter placement. <\/jats:p><\/jats:sec><jats:sec><jats:title>Case report<\/jats:title><jats:p> A 45-year-old male patient of African descent presented with a malfunctioning right forearm AVF and aneurysm formation in the arm. Clinical examination revealed a soft, low-flow forearm fistula merging into a high-flow and pulsatile AVF outflow aneurysm in the arm. Multiple well healed surgical incisions were present. Ultrasound examination revealed two separate AVFs. One was a low-flow radiocephalic AVF at the wrist that was used routinely for cannulation in the forearm, although with some difficulty due to low inflow pressure. The second AVF, a brachiocephalic anastomosis, was pulsatile, aneurysmal, and not in use. Blood flow in the proximal brachial artery was 3.0 L\/min. Surgeon-performed ultrasound (SP-US) was used perioperatively to plan the surgical approach and incision, closing the existing brachial anastomosis and creating a veno-venous anastomosis between both outflow veins, establishing a mature and undisturbed cannulation conduit from the wrist through the arm. The revised AVF was immediately usable for hemodialysis with restored normal AVF flow in the forearm and appropriately reduced flow in the arm. Importantly, dialysis catheter placement was avoided. <\/jats:p><\/jats:sec>","DOI":"10.5301\/jva.5000731","type":"journal-article","created":{"date-parts":[[2017,5,7]],"date-time":"2017-05-07T10:48:35Z","timestamp":1494154115000},"page":"359-361","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Perioperative ultrasound: a critical element in diagnosis and salvage of complex vascular access dysfunction"],"prefix":"10.1177","volume":"18","author":[{"given":"Alexandros","family":"Mallios","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery, Institut Mutualiste Montsouris, Paris - France"},{"name":"Polyclinique de Villeneuve St. George, Ramsay \u2013 Generale de Sante, Villeneuve St. George - France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hadia","family":"Hebibi","sequence":"additional","affiliation":[{"name":"Hemodialysis Unit, Nephrocare, Bievres - France"},{"name":"Nephrology Department, University Hospital, Kremlin-Bic\u00eatre, Paris - France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Jennings","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Oklahoma College of Medicine, Tulsa, OK - USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,5,5]]},"reference":[{"key":"bibr1-jva.5000731","unstructured":"National Kidney Foundation-K\/DOQI Clinical Practice Guidelines for Vascular Access. Update 2006. Available from http:\/\/www2.kidney.org\/professionals\/KDOQI\/guideline_upHD_PD_VA\/. Accessed March 23, 2017."},{"key":"bibr2-jva.5000731","unstructured":"Fistula First: National Vascular Access Improvement Initiative. Available from http:\/\/www.fistulafirst.org. Accessed March 23, 2017."},{"key":"bibr3-jva.5000731","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(02)01103-0"},{"key":"bibr4-jva.5000731","doi-asserted-by":"publisher","DOI":"10.5301\/jva.5000569"},{"issue":"5","key":"bibr5-jva.5000731","doi-asserted-by":"crossref","first-page":"e17","DOI":"10.1053\/j.ajkd.2004.01.016","volume":"43","author":"MacRae JM","year":"2004","journal-title":"Am J Kidney Dis"},{"key":"bibr6-jva.5000731","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2015.08.012"},{"key":"bibr7-jva.5000731","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-139X.2006.00185.x"}],"container-title":["The Journal of Vascular Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.5301\/jva.5000731","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.5301\/jva.5000731","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.5301\/jva.5000731","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,2]],"date-time":"2025-03-02T01:04:02Z","timestamp":1740877442000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.5301\/jva.5000731"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5,5]]},"references-count":7,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2017,7]]}},"alternative-id":["10.5301\/jva.5000731"],"URL":"https:\/\/doi.org\/10.5301\/jva.5000731","relation":{},"ISSN":["1129-7298","1724-6032"],"issn-type":[{"type":"print","value":"1129-7298"},{"type":"electronic","value":"1724-6032"}],"subject":[],"published":{"date-parts":[[2017,5,5]]}}}