Top Tips for fistula scanning

5 Top Tips for fistula scanning

by Tracey Griffin, Team Lead for Ultrasound at Raigmore Hospital, Inverness

1. It's helpful to scan the patient in a chair rather than the couch, with arm supported on a pillow, palm face up.  With the lights still on, look at the fistula first, look for the type of needling, ie: buttonholes or rope ladder technique.  Look for aneurysmal areas, look for any areas of redness or swelling, look for any "dips" in the main fistula vein, which may suggest a narrowing

2. Feel the thrill!  Palpate the length of the fistula with your fingers first to feel for a bruit or a pulse.  A pulse within the main fistula vein is suggestive of a stenosis

3. Optimise the machine first, set the colour and spectral flows to high before you start the scan

4. Keep the room warm, a cold environment will affect the fistula

5. Sweep up the fistula with colour Doppler on, in transverse section, looking for any obvious stenoses before assessing the fistula fully. Vital information is obtained by observing the colour flow