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Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)

CPT4 code

Name of the Procedure:

Duplex Scan of Hemodialysis Access
Common name(s): Ultrasound of Hemodialysis Access

Summary

A duplex scan of hemodialysis access is a specialized ultrasound procedure used to evaluate the blood vessels that facilitate dialysis treatment. It examines the arterial inflow, the body of the access (such as an arteriovenous fistula or graft), and the venous outflow.

Purpose

This procedure identifies and assesses any blockages, narrowings, or dysfunctions in the blood vessels used for hemodialysis. The goal is to ensure the hemodialysis access is functioning correctly for effective dialysis treatment.

Indications

  • Decreased efficiency of dialysis
  • Swelling or redness around the access site
  • Difficulty in cannulating (inserting needles into) the access
  • Suspected stenosis or thrombosis
  • Routine evaluation in patients with longstanding dialysis access

Preparation

  • No special preparation is typically required.
  • Continue taking prescribed medications unless otherwise instructed by your provider.
  • Wear loose, comfortable clothing that can easily be removed or adjusted.

Procedure Description

  1. You will lie on an examination table.
  2. A water-based gel is applied to the skin over the access site.
  3. A technician or radiologist uses a handheld transducer (ultrasound probe) to send and receive sound waves.
  4. The transducer is moved systematically over the access area to obtain images of the arterial inflow, the body of the access, and the venous outflow.
  5. The images and flow diagrams are recorded and analyzed.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

The procedure is usually performed in an outpatient clinic, hospital, or dialysis center.

Personnel

  • Ultrasonographer or radiologist
  • Occasionally, a nurse or a technician specializing in vascular access

Risks and Complications

  • Generally a very low-risk procedure.
  • Rare risks: Discomfort from the pressure of the transducer, especially over a tender or swollen area.

Benefits

  • Non-invasive and painless method.
  • Helps maintain and enhance the effectiveness of dialysis treatment by identifying issues early.
  • Immediate results can guide further treatment or interventions.

Recovery

  • No recovery time is needed.
  • Normal activities can be resumed immediately after the procedure.
  • Follow-up appointment may be scheduled to discuss the results.

Alternatives

  • Angiography (invasive imaging technique)
  • Physical examination and palpation (less detailed assessment)
  • Monitoring dialysis effectiveness through blood tests (less direct assessment of access condition)

Patient Experience

  • You may feel slight pressure from the ultrasound probe.
  • The gel may feel cold but is harmless.
  • No significant pain is expected, and comfort measures are usually not necessary.

This markdown provides a comprehensive overview of the Duplex Scan of Hemodialysis Access, offering clear and concise information tailored for patients and healthcare providers alike.

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