Dialysis Access

AV Access Steal Study

1. Digit pressure index (DBI) >0.60 considered within normal limits; DBI that is above 0.60 with fistula open does not support diagnosis of clinically significant steal.  

a. Significant increase in DBI from <0.60 with access open to >0.60 with access closed is consistent with clinically significant steal

b. If waveform amplitude doubles from open access to closed access tracing, this is consistent with clinically significant steal

AV Access Mapping: Acceptable Parameters

1. Vein diameters >2.5 mm

2. No evidence for DVT or SVT

3. No central vein obstruction

4. Identify vein wall or chronic intraluminal changes

5. Arterial diameters >2.0

6. No evidence for significant arterial inflow disease

7. Identify arterial segments that show significant wall calcification