ACR AC Portal

Home Dialysis Fistula Malfunction

Variants

Clinical suspicion of central venous stenosis or occlusion suggested by swelling (ie, soft tissue edema) of the extremity ipsilateral to the upper or lower extremity hemodialysis access, with or without the development of venous collaterals. Initial imaging to guide interventional radiologic therapy options.

Documents

Scenario

Scenario ID

Procedure

Adult RRL

Peds RRL

Appropriateness Category

Hemodialysis access, lower extremity, ipsilateral extremity swelling, with or without venous collaterals, central venous occlusion suspected, initial imaging, guide IR therapy

3196494

Fluoroscopy fistulography hemodialysis access lower extremity

1-10 mSv
☢☢☢

Usually appropriate

CTA lower extremity with IV contrast

1-10 mSv
☢☢☢

3-10 mSv [ped]
☢☢☢☢

Usually not appropriate

CTV lower extremity with IV contrast

10-30 mSv
☢☢☢☢

Usually not appropriate

MRA lower extremity without and with IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

MRA lower extremity without IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

MRV lower extremity without and with IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

MRV lower extremity without IV contrast

0 mSv
O

0 mSv [ped]
O

Usually not appropriate

US duplex Doppler hemodialysis access lower extremity

0 mSv
O

0 mSv [ped]
O

Usually not appropriate