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Vascular access dysfunction, especially stenosis and thrombosis, causes morbidity, repeated interventions, and hospitalization. Surveillance and monitoring aim to detect hemodynamically significant stenosis early, reducing thrombosis risk and preserving access patency. Meta-analyses and randomized trials suggest Qa-based surveillance may lower thrombosis in arteriovenous fistulas, while benefits are less consistent for grafts. Guidelines generally support routine Qa surveillance for AVFs but not standard practice for AVGs. Limitations in prior studies include heterogeneous protocols and definitions. More rigorous trials are needed, and emerging tools such as artificial intelligence and wearable devices for continuous monitoring may improve diagnostic accuracy, enable earlier detection, and reduce intervention burden, pending further validation.",{"@graph":69,"@context":114},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/hemodialysis-vascular-access-flow-surveillance-current-evidence-and-future-directions/433702/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/hemodialysis-vascular-access-flow-surveillance-current-evidence-and-future-directions/433702.png","ImageObject",300,407,{"name":92,"@type":93},"Emma Wilson","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108],{"name":109,"@type":110,"acceptedAnswer":111},"How do benefits of Qa surveillance differ between AVFs and AVGs?","Question",{"text":112,"@type":113},"Evidence indicates greater and more consistent benefit for arteriovenous fistulas, while results for arteriovenous grafts are less consistent and guidelines typically do not recommend Qa surveillance as routine standard practice for AVGs.","Answer","https://schema.org",{"og:url":83,"og:type":116,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":118,"canonical":83},"index,follow",{"doc_id":120,"site_id":62},433702,1791249835,{"code":4,"msg":5,"data":123},{"doc_id":120,"user_id":124,"nickname":92,"user_avatar":125,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":126,"file_id":127,"file_url":128,"file_type":129,"file_size":130,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":131,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":132,"faqs":133,"seo_title":134,"seo_description":67,"update_tm":135,"read_time":136,"preview_page_count":4},3848291630094,"https://eur-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","J Chin MedAssoc  \nReview ARticle  \nHemodialysis vascular access flow surveillance: Current evidence and future directions  \nTz-Heng Chena,b,c, Yan-Ting Shiud,e, Timmy Leef, Chih-Yu Yanga,b,g,h,i,*, Der-Cherng Tarnga,b,g,h,*  \naDivision of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; bSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; cInstitute of Emergency and Critical Care Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; dDivision of Nephrology and Hypertension, Department of Internal Medicine, University of Utah, Salt Lake City, Utah; eNora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah; fDepartment of Medicine and Division of Nephrology, University of Alabama at Birmingham, Birmingham, Alabama; gInstitute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; hCenter for Intelligent Drug Systems and Smart Bio-devices (IDS2B), National Yang Ming Chiao Tung University, Hsinchu, Taiwan, ROC; iStem Cell Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC  \nAbstract  \nA well-functioning vascular access is essential for delivering adequate hemodialysis in patients with end-stage renal disease. However, vascular access dysfunction, particularly stenosis and thrombosis, remains a leading cause of morbidity, repeated interventions, and hospitalization in this patient population. Vascular access monitoring and surveillance are designed to detect hemodynamically significant stenosis early, thereby reducing the risk of thrombosis and maintaining access patency. Evidence from meta-analyses and randomized controlled trials suggests that access blood flow (Qa)-based surveillance may lower thrombosis rates in arteriovenous fistulas (AVFs), while the benefit appears less consistent for arteriovenous grafts (AVGs) . Consequently, most guidelines recommended incorporating Qa surveillance into routine clinical monitoring for AVFs, but not as a standard practice for AVGs. However, previous studies have notable limitations, including heterogeneous surveillance protocols and variable definitions of access dysfunction. More rigorously designed randomized controlled trials are needed to clarify the role of Qa surveillance and inform optimal strategies. Looking ahead, emerging technologies such as artificial intelligence and wearable devices for continuous monitoring hold promise for enhancing diagnostic accuracy, enabling earlier detection of dysfunction, and reducing the need for intervention rates. Integrating these innovations with standardized surveillance protocols and individualized patient risk stratification has the potential to improve vascular access longevity, reduce the healthcare burden, and improve outcomes in the hemodialysis population, although further validation is required.  \nKeywords: Flow surveillance; Hemodialysis vascular access; Noninvasive monitoring; Stenosis detection; Wearable devices  \n[www.ejcma.org](www.ejcma.org) 815  \nChen et al. J Chin MedAssoc  \nLay Summary: This review explores hemodialysis vascular access flow surveillance and its importance in maintaining reliable dialysis care. It explains the pathophysiology of access dysfunction and outlines monitoring approaches, ranging from clinical examination to device-based methods such as the ultrasound dilution technique and Doppler ultrasound. We summarize key clinical guidelines, randomized trials, and meta-analyses, which indicate that access blood flow surveillance provides greater benefit in arteriovenous fistulas than in arteriovenous grafts. Finally, the review highlights future directions, including artificial intelligence, wearable devices, and remote monitoring systems, that may enable earlier detection of dysfunction and support more personalized patient care.  \n1. INTRODUCTION  \nVascular access is the lifeline for patients with end-stage kid","cbCaivBpPV5QyGNH","https://ap.wps.com/l/cbCaivBpPV5QyGNH","pdf",2294391,"English","# Introduction\n# Pathophysiology of Vascular Access Dysfunction","[{\"question\":\"How do benefits of Qa surveillance differ between AVFs and AVGs?\",\"answer\":\"Evidence indicates greater and more consistent benefit for arteriovenous fistulas, while results for arteriovenous grafts are less consistent and guidelines typically do not recommend Qa surveillance as routine standard practice for AVGs.\"}]","Hemodialysis vascular access flow surveillance: Current evidence and future directions | PDF",1790665180,25]