the femoral vein could reduce the malposition rate in adult patients,especially when using a hand-carried ultrasound device.Methods: Thirty catheters inserted with guidance using a ultrasonog-raphy device (ultrasound group) and 65 catheters inserted using aconventional procedure (conventional group) were compared by retro-spective cohort regarding the malposition rate. First, the operatorpunctured the femoral vein via an external landmark-guided techniquein both groups. The ultrasound examiner next identified the tip of theCVC located dorsal to the liver in the inferior vena cava (IVC), andthen the operator fixed the catheter. Malposition was defined as a CVCtip being neither in the IVC nor in the right atrium-inferior vena cavajunction seen by X-ray. Abnormal flexion or inversion of the catheterwas also judged as malposition.Results: Malposition was identified in two cases (6.9%) in the ultra-sound group and 19 cases (29.2%) in the conventional group. Therelative risk of ultrasound-guided versus conventional insertion was0.23 and the 95% confidential interval was 0.09 to 0.62.Conclusions: The real-time ultrasound-guided cannulation is useful forpreventing malposition of a CVC inserted from the femoral vein.

3561

The assessment of blood flow in vena cava inferior after fattymeal testYatsenko NJ, Michaluk OV, Simonova IM, Nelassov NJ, RostovMedical University, Russian Federation

Objectives: To analyze the change of the diameter and velocity ofblood flow in vena cava inferior after the intake of meal.Methods: Ten healthy persons (mean age 38.4 � 3.9 years) wereexamined before and 45 minutes of intake of 200 ml of fat yogurt.Results: The average diameter of vena cava inferior did not changesignificantly (before: at inspiration 17.72 � 1.1 mm, at expiration 14.79� 1.0 mm; after: 18.21 � 1.0 mm (p � .05) and 15.36 � 1.1 mm (p� .05), respectively). The velocity in all three components of cardiaccycle increased at inspiration after test (before: systolic 20.93 � 2.0cm/s, early diastolic 16.8 cm/s, atrial –14.78 � 1.2 cm/s; after: 29.1 �4.1 cm/s (p � .05); 20.2 � 3.0 cm/s (p � .05); –20.9 � 2.0 cm/s (p �.05), respectively). The velocity at expiration in different phaseschanged in different manner (systolic, early diastolic and atrial com-ponents before test were 45.1 � 6.3 cm/s, 29.2 � 5.8 cm/s and 24.6 �2.0 cm/s and became 45.9 � 5.8 cm/s (p � .05), 26.1 � 3.8 cm/s (p �.05) and 31.1 � 4.8 cm/s (p � .05).Conclusions: Our results demonstrate that hemodynamic changes afterintake of meal appear not only in vena porta but also in system of venacava inferior. These changes should be taken into account while per-forming vascular examinations.

3562

The exercise effect of predialysis patient by measurement of flowmediated dilationKu Y-M, Chun K-A, Song S-W, Kim K-T, The Catholic University ofKorea, Korea

The purpose of this study are to assess of the exercise effect ofpre-dialysis patient by measurement of FMD (flow mediated dilation)using the ultrasonography. The 15 predialysis CRF patient was enrolledand measuring the FMD using ultrasound at the period between pre-exercise and post-exercise after 6-wk exercise program. The exercise isuseful method increasing the vascular endothelial function.

3563

Duplex ultrasonic examination of left subscapular artery usedfor predicting problems in transaxillary approachTsygankov VN, Gaman SA, A. V. Vishnevsky Institute of Surgery,Russian Federation; Cardiology Research Complex, RussianFederation

Axillary artery catheterization is frequently used in angiographic ex-aminations. Meanwhile, in 10% of patients, we have significant diffi-culties during catheterization because of atypical origin of subscapularartery. As a result the guide-introducer cannot be conducted intosubclavial artery through axillary artery, and gets into subscapularartery instead. We suggest using a new ultrasonic approach in whichsubscapular artery entry can be visualized. Ultrasonic examination ofsubscapular and axillary arteries in B-mode was performed in 30patients who were prepared to undergo angiography from transaxillaryapproach. We defined subscapular artery atypical origin predictors:subscapular artery diameter to axillary artery diameter ratio �0.7;angle between proximal segments of subscapular and axillary arteries�95°. Therefore, we believe that ultrasonic examination of subscapularand axillary arteries before catheterization can make procedure ofangiography more effective and less complicated.

3564

Hemodialysis access stenosis: Accuracy of the color Doppler UScompared with fistulographySong SJ, Lee W, Park JH, Chung JW, Seoul National UniversityHospital, Korea

Objectives: To evaluate the role and usefulness of diagnostic ultra-sonography (US) in accurate assessment of stenosis of hemodialysisaccess fistulas.Methods: Forty-four patients who had undergone color Doppler USand fistulography within 5 days concomitantly between May 2003 toMay 2004 were included. To assess the presence of stenosis or throm-bosis, average volume of flow, peak systolic velocity and diameter ofresidual lumen were recorded; additionally, increased echogenicitywithin the vessel on gray scale and decreased volume flow weremeasured.Results: At US, 42 of the 44 patients had evidence of stenosis orthrombosis. In 34 of the 44 patients, initial access on Doppler US wasaccurate. More central venous stenoses were found at fistulographythan at US.Conclusions: Color Doppler US is useful and reliable method foraccurate assessment of fistula stenosis or thrombosis. Routine colorDoppler US of fistulas should be considered to identify and correctflow-limiting stenoses that may compromise long-term patency offistula and use in patients suspected of having hemodialysis accessdysfunction.

3565

The impact of sonographic vascular mapping on the planninghemodialysis arteriovenous fistula: Does it change the surgeon’splan before vascular access procedure and what are the results?Lee SY, Song S-Y, Koh BH, Cho OK, Kim Y, Kwon OJ, Lee CH,Hanyang University College of Medicine, Korea

Objectives: To evaluate the impact of preoperative sonographic eval-uation on the surgical plan for hemodialysis fistula and their outcomes.Methods: During the 6-month period, we performed sonographic vas-cular mapping in 23 patients who was planed for radiocephalic fistulaformation at the distal forearm. If feeding artery or draining vein hadinadequate diameter (�1.5 mm and/or �2 mm, respectively), the

Abstracts P287