To be able to prolong the longevity of the access it is of importance not to act too soon nor to act too late when a stenosis is present. Defining a hemodynamical stenosis solely by visible diameter reduction combined with PSV increase is not precise enough to determine if the stenosis jeopardizes the patency of the vascular access or not.
Treatment of all stenosis defined only by diameter reduction >50% without including additional criteria would increase the number of interventions considerably with potential harm to the patients. The added value of the abovementioned additional parameters are/will be summarized in more detail in the coming supplement of this journal dedicated to Ultrasonography.