AV SONOPATH study
Research type
Research Study
Full title
CORRELATION OF DUPLEX ULTRASOUND WITH HISTOPATHOLOGY OF HAEMODIALYSIS ARTERIO-VENOUS FISTULA STENOTIC LESIONS – A PROSPECTIVE STUDY
IRAS ID
254077
Contact name
Kate Steiner
Contact email
Sponsor organisation
East and North Hertfordshire NHS Trust
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
Arteriovenous fistulas (AVFs) are a connection between an artery and a vein usually created by a surgeon and are the best way a patient can receive haemodialysis. When they do not provide effective dialysis, are causing the patient problems on dialysis or clot and cannot be used this is usually caused by a narrow segment of vein known as a stenosis.
Significant stenosis can be diagnosed and assessed using duplex ultrasound (DUS). Duplex ultrasound is an ultrasound examination, which assesses flow within the fistula and also can measure the extent of thickening of the innermost layer of vessel wall (referred to as intimal-Medial thickening). There is mounting evidence that AVF stenoses are not a uniform group and that different types of stenosis may respond to treatment differently.
Histology analysis of a stenosis is the gold standard for assessment of IMT/hyperplasia and also can assess types of stenosis in more detail, in particular, looking at the type of cells and the vessel wall involved.
The primary aim of this study is to confirm DUS findings of intimal-medial thickening correlate with venous neo-intimal hyperplasia seen on histology. Secondary aims are to define the different types of AV access stenosis based on DUS and histology assessment.
When surgery for treatment of an AVF stenosis is planned to treat an AVF which has clotted or is not functioning well a DUS assessment of the stenosis will be performed. At the time of the surgery, the stenotic segment of vein is removed. This will be collected and sent to the histology department where it will be prepared by being cut into small sections and then examined under the microscope.
Radiology-pathology correlation is essential to understanding pathology seen on imaging and understanding what pathology is being treated when performing dialysis access interventions.REC name
East of England - Cambridge Central Research Ethics Committee
REC reference
19/EE/0142
Date of REC Opinion
11 Apr 2019
REC opinion
Favourable Opinion