Upper limb DVT after hemodialysis

• Main Author: Tamer W. Kassem
• Format: Article
• Language: English
• Published: SpringerOpen 2016-09-01
• Series: The Egyptian Journal of Radiology and Nuclear Medicine
• Subjects: Upper limb; Thrombosis; Hemodialysis AVF; CT venography
• Online Access: http://www.sciencedirect.com/science/article/pii/S0378603X16300705

Objective: The aim of this study was to assess the role of CT venography (CTV) in diagnosis of upper limb deep venous thrombosis (DVT) after arterio-venous fistula (AVF) creation for patients with chronic renal failure (CRF) under regular hemodialysis. Patients and methods: During two years duration 22 patients with upper limb hemodialysis arterio-venous fistulas suspected to have deep venous thrombosis were prospectively evaluated. All patients underwent CTV examinations following a preset protocol. The images obtained were reconstructed using dedicated software and workstations. Results of CTV examinations were compared with those of Color Doppler (CD) examinations. Results: Out of 22 examined cases, 20 cases (90.9%) had autogenous AVF and 2 cases (9.1%) had synthetic grafts. Diagnosis of proximal upper limb segment DVT including brachial, axillary and subclavian veins recorded 12 TP (54.5%), 8 TN (36.4%), 2 FP (9.1%) and no FN cases. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 100%, 80%, 85.7% and 100% respectively. Diagnosis of central venous segment DVT including innominate veins and SVC recorded 14 TP (63.6%), 8 TN (36.4%) and neither FP nor FN cases. Sensitivity, specificity, PPV and NPV were 100%, 100%, 100% and 100% respectively. Conclusion: CTV has a major role in diagnosis of deep venous thrombosis particularly the central innominate veins/SVC segment after upper limb AVF creation for patients with CRF under hemodialysis.