scholarly journals Discriminative Role of Brachial Artery Doppler Parameters in Correlation with Hemodialysis Arteriovenous Fistula

2017 ◽  
Vol 90 (4) ◽  
pp. 407-410
Author(s):  
Burak Mehmet Çildağ ◽  
Kutsi Ömer Faruk Köseoğlu
Keyword(s):  
Arteriovenous Fistula ◽  
Brachial Artery ◽  
Venous Pressure ◽  
Resistive Index ◽  
Normal Function ◽  
Flow Volume ◽  
Pump Flow ◽  
Flow Parameters ◽  
Significant Difference ◽  
Hemodialysis Arteriovenous Fistula

Purpose. The aim of this study was to evaluate the flow volume and resistive index parameters of the brachial artery in the functioning and dysfunctioning radiocephalic and brachiocephalic hemodialysis arteriovenous fistula (AVF).Methods. 82 patients were distributed into three groups according to their hemodialysis function - as normal function, decreased pump flow and increased venous pressure. Flow volumes and resistive indexes (RI) of the brachial artery of radiocephalic and brachiocephalic AVFs were measured by Doppler ultrasound. Flow parameters of the groups were compared. Results. A statistically significant difference was found between the normal and decreased pump flow groups in terms of flow volume and resistive index values. 770 ml/min flow volume of the brachial artery has a 94% sensitivity and 84% specificity and 0.52 value of RI has an 89% sensitivity and 88% specificity in the the differentiation of normal and decreased pump flow groups.Conclusion. Doppler parameters of the brachial artery such as flow volume and RI can provide valuable information about AVF function.

Predictive value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio for primary patency of percutaneous transluminal angioplasty in hemodialysis arteriovenous fistula stenosis

Vascular ◽  
2021 ◽  
pp. 170853812110396
Author(s):  
Feng Zhu ◽  
Yao Yao ◽  
Hongbo Ci ◽  
Alimujiang Shawuti
Keyword(s):  
Arteriovenous Fistula ◽  
Percutaneous Transluminal Angioplasty ◽  
Transluminal Angioplasty ◽  
Primary Patency ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Significant Difference ◽  
Percutaneous Transluminal ◽  
Hemodialysis Arteriovenous Fistula

Objective The aim of this study is to investigate the potential association of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with the primary patency of percutaneous transluminal angioplasty (PTA) in hemodialysis arteriovenous fistula (AVF) stenosis. Methods This study conducted a retrospective review of patients with end-stage renal disease referred for hemodialysis AVF stenosis in one center. The study consisted of 114 patients with significant (significant stenosis was defined as a reduction in the caliber of the fistula vein of > 50% with respect to the non-aneurysmal venous segment). AVF stenosis patients were treated with PTA, with conventional balloon angioplasty. The NLR and PLR were calculated from the pre-interventional blood samples. The patients were classified into two groups: group A, primary patency < 12 months ( n = 35) and group B, and primary patency ≥ 12 months ( n = 79). Comparisons between the groups were performed using the Mann–Whitney U test. Kaplan–Meier analysis was performed to compare the factors, NLR and PLR, for association with primary patency AVFs. A receiver-operating characteristic curve analysis was performed to identify the sensitivity and specificity of the NLR and PLR cut-off values in the prediction of primary patency time. Results There was no difference in gender; age; side of AVF; AVF type; comorbid diseases such as diabetes mellitus and hypertension; or blood parameters such as white cell count, erythrocytes, hemoglobin, neutrophils, lymphocytes, monocytes, eosinophils, basophils, C-reactive protein, NLR, or PLR between the two groups ( p > 0.05). There was also no significant difference in the patency rate between the NLR < 4.13 and NLR ≥ 4.13 groups at 12 months (NLR cut-off point = 4.13, p = 0.273). There were statistically significant differences between the primary patency rates of the PLR < 187.86 and PLR ≥ 187.86 groups at 12 months (PLR cut-off point = 187.86, p = 0.023). The cut-off value for PLR for the determination of primary patency was 187.86, with a sensitivity of 57.0% and specificity of 34.4%. Conclusion An increased level of PLR may be a risk factor for the development of early AVF restenosis after successful PTA. However, more studies are needed to validate this finding.

Late Occurrence of a Large Brachial Artery Aneurysm following Closure of a Hemodialysis Arteriovenous Fistula

2006 ◽  
Vol 20 (4) ◽  
pp. 533-535 ◽  
Author(s):  
Luciano Battaglia ◽  
Federico Bucci ◽  
Mario Battaglia ◽  
Adriano Reddler
Keyword(s):  
Arteriovenous Fistula ◽  
Brachial Artery ◽  
Artery Aneurysm ◽  
Hemodialysis Arteriovenous Fistula

Arteriovenous fistula and pre-surgery mapping: Potential role of physical exercise on endothelial function

2019 ◽  
Vol 20 (6) ◽  
pp. 652-658 ◽  
Author(s):  
Giulio Distefano ◽  
Luca Zanoli ◽  
Antonio Basile ◽  
Pasquale Fatuzzo ◽  
Antonio Granata
Keyword(s):  
Physical Exercise ◽  
Endothelial Function ◽  
Arteriovenous Fistula ◽  
Radial Artery ◽  
Upper Limb ◽  
Brachial Artery ◽  
Resistance Index ◽  
Resistive Index ◽  
Flow Mediated Dilation ◽  
The Impact

Background: The success of the construction of an arteriovenous fistula for haemodialysis is related to the vascular function of the vessels involved in the anastomosis, with particular reference to radial artery distensibility after reactive hyperaemia test and to the fall of resistance index. Only few studies have evaluated the impact of exercise protocols on the endothelial and morphological characteristics of the vessels of the upper limb with inconclusive results. In this pilot longitudinal study, we aimed to evaluate the impact of a standardized exercise protocol on the haemodynamic and resistive index of the arteries of the upper limb of uraemic patients. Methods: A total of 17 uraemic patients planned to construct arteriovenous fistula at the distal third of the forearm were enrolled and followed up for 30 days. All patients performed repeated handgrips for 30 min/day. The arterial parameters were detected before and after an ischaemic stress of 5 min and radial and brachial artery flow-mediated dilation was evaluated as well as radial artery resistance index. Results: Pre-exercise measurements of radial artery diameter and resistance index and brachial artery diameter were not modified by 30 days hand physical exercise, whereas the post-exercise haemodynamic were improved. Consequently, flow-mediated dilation of the radial artery was improved (21% ± 14% vs 30% ± 19%; p = 0.03) and resistance index of the radial artery was reduced ( p = 0.02). Conclusion: Exercise has beneficial effects on endothelial function of the radial artery by resistive index and, potentially, on the outcome of the arteriovenous fistula. Further studies with larger sample size are needed to confirm our preliminary data.

Quantitative Evaluation of the Systemic Effects of Transposed Basilic Vein to Brachial Artery Arteriovenous Fistula: A Prospective Study

2008 ◽  
Vol 9 (4) ◽  
pp. 285-290 ◽  
Author(s):  
N. Saratzis ◽  
A. Saratzis ◽  
P.A. Sarafidis ◽  
N. Melas ◽  
K. Ktenidis ◽  
...  
Keyword(s):  
Blood Flow ◽  
Arterial Pressure ◽  
Arteriovenous Fistula ◽  
Cardiac Failure ◽  
Brachial Artery ◽  
Systemic Arterial Pressure ◽  
Flow Volume ◽  
Basilic Vein ◽  
Blood Flow Volume ◽  
Steal Syndrome

Background The transposed basilic vein to brachial artery arteriovenous fistula (BBAVF) constitutes an alternative autogenous vascular access (VA) site for chronic hemodialysis (HD); however, the hemodynamic effects of this procedure have not been adequately studied. The purpose of this study is to evaluate the effects of BBAVF on systemic arterial pressure, cardiac function, and upper limb ischemia (ischemic steal syndrome) utilizing reproducible quantitative methods. Methods Ten consecutive patients (eight males; mean age: 65.10 ± 2.87 yrs) scheduled to undergo a brachial-basilic vein transposition were included, excluding patients with cardiac failure. Blood flow volume at the level of the AVF, systemic arterial pressure (SAP), cardiac output (CO) and digital brachial index (DBI) were measured intra-operatively, before and after the creation of the BBAVF, and post-operatively on the 30th post-operative day and on the 3rd post-operative month. Results SAP and DBI at 30 days and 3 months post-operatively were significantly lower compared to baseline. CO at 30 days and 3 months post-operatively was significantly higher compared to baseline; however, none of the patients developed cardiac failure. DBI remained ≥0.6 at 3 months, except in one case (0.59). Blood flow volume at the level of the AVF was positively correlated with CO levels on the 30th post-operative day. Mean clinical follow-up was 12 months (range: 4–15 months). In two cases (20%) the AVF was thrombosed (4th and 10th post-operative month). Conclusion This prospective quantitative study proves that the BBAVF does impact significantly upon SAP, CO, and DBI; however, it is safe in terms of high-output cardiac failure and ischemic steal syndrome. The authors state that they do not have any commercial, proprietary, or financial interest in any products or companies described in this article.

The Relationship Between Posterior Communicating Artery Formation and Vertebral Artery Flow Parameters

2021 ◽  
pp. 875647932110059
Author(s):  
İbrahim Önder Yeniçeri ◽  
Vedat Semai Bek ◽  
Neşat Çullu ◽  
Gülnihal Kutlu
Keyword(s):  
Vertebral Artery ◽  
Duplex Sonography ◽  
Posterior Communicating Artery ◽  
Vertebrobasilar Insufficiency ◽  
Flow Volume ◽  
Mean Velocity ◽  
Flow Parameters ◽  
Diastolic Velocity ◽  
Significant Difference ◽  
The Relationship

Objectives: It is important to know the range of normal vertebral artery (VA) flow volume. Diminished VA flow volume is associated with vertebrobasilar insufficiency. The study aim was to investigate the relationship between the posterior communicating artery (PCoA) calibration and the VA flow parameters, in patients with no underlying cerebrovascular disease, below 50 years of age. Materials and Methods: The study population consisted of 102 cases below 50 years of age. The basilar artery (BA), internal carotid artery (ICA), and the PCoA calibrations were measured with magnetic resonance angiography. The VA flow parameters (maximum systolic velocity, end-diastolic velocity, mean velocity, VA flow volume, and VA calibration) were measured with duplex sonography. Results: There was no statistically significant difference between these two imaging groups, in terms of VA Vmax, VA flow volumes, VA calibrations, and BA calibrations. However, the mean right ICA and mean left ICA calibrations were significantly higher in group 2 than group 1 ( P < .01). There was no significant correlation between mean PCoA calibration and mean Vmax, mean calibration, and the total flow volume of vertebral arteries. Conclusion: The findings indicate that the VA flow rate may be relatively maintained, regardless of PCoA measurements in this study.

scholarly journals Hemodialysis arteriovenous fistula ligation after renal transplantation: Impact on graft resistive index

2020 ◽  
pp. 112972982092724
Author(s):  
Marica Magnetti ◽  
Gianluca Leonardi ◽  
Cesare Guarena ◽  
Caterina Dolla ◽  
Rita Tarragoni ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Estimated Glomerular Filtration Rate ◽  
Antihypertensive Drugs ◽  
Heart Function ◽  
Resistive Index ◽  
Immunosuppressive Drug ◽  
Blood Levels ◽  
Kidney Allograft ◽  
Kidney Perfusion ◽  
Hemodialysis Arteriovenous Fistula

Background: Kidney allograft resistive index (RI) is prognostic for graft and recipient survivals. Recipient hemodynamics could influence RI. In particular, dialysis arteriovenous fistula (AVF) has been involved in heart function changes, reversible after AVF ligation. Knowledge about AVF and RI is lacking. In this study, we prospectively evaluated RI changes after AVF ligation in kidney transplanted patients. Methods: We enrolled 22 stable transplanted patients. Mean RI was measured before AVF ligation (T0), 18 to 24 h (T1) and 6 months (T6) after surgery; mean blood pressure (mBP), heart rate (HR), serum creatinine (sCr), estimated glomerular filtration rate (eGFR), 24 h proteinuria (24 h-P), immunosuppressive drug blood levels (IS) and antihypertensive drugs were also recorded. Results: AVF ligation was performed 3.1 years (IQR: 2.1–3.8) after transplantation. Median AVF flow (Qa) was 1868 mL/min (IQR: 1538–2712) and 8 AVF were classified as high flow (Qa ≥ 2 L/min). At baseline, median sCr was 1.32 mg/dL (IQR: 1.04–1.76) and median eGFR was 57.1 mL/min. Median RI was 0.71 at T0, 0.69 at T1, 0.66 at T6. RI reduction at T1 and T6 was statistically significant (p < 0.05 and p < 0.001 respectively); in particular, 90.4% of patients had persistently improved values at T6. Furthermore, mBP increased while HR decreased. These changes were independent from sCr, 24 h-P, IS, antihypertensive drugs number, Qa and AVF type. Conclusions: AVF ligation improves kidney allograft RI; it may reflect better kidney perfusion.

scholarly journals Accuracy of doppler ultrasonography in the evaluation of hemodialysis arteriovenous fistula maturity

2015 ◽  
Vol 42 (3) ◽  
pp. 138-142 ◽  
Author(s):  
João Humberto da Fonseca Junior ◽  
Guilherme Benjamin Brandão Pitta ◽  
Fausto Miranda Júnior
Keyword(s):  
Arteriovenous Fistula ◽  
Roc Curve ◽  
Doppler Ultrasonography ◽  
Characteristic Curve ◽  
Receiver Operator Characteristic Curve ◽  
Receiver Operator Characteristic ◽  
Flow Volume ◽  
Vein Diameter ◽  
Hemodialysis Arteriovenous Fistula ◽  
Measured Volume

<sec><title>OBJECTIVE:</title><p> to determine the accuracy of Doppler ultrasonography (USD) for hemodialysis arteriovenous fistula (AVF) maturity.</p></sec><sec><title>METHODS:</title><p> we included patients with no prior AVF. Each patient underwent two USD examinations. After initiation of hemodialysis, we followed the patients during the first month of the access use and verified its adequacy to hemodialysis sessions. At statistical analysis we measured specificity, sensitivity, accuracy, ROC curve (Receiver operator characteristic) curve, TG-ROC (Two graph - receiver operator characteristic) and logistic regression.</p></sec><sec><title>RESULTS:</title><p> we included 76 patients, of which 51 completed the study. They formed two groups, those who have had good adequacy for hemodialysis (45) and those who had not (6). The average flow volume (FV) and the average draining vein diameter (DVD) of each group were, respectively: 940mL/min (95% CI: 829-1052) and 325mL/min (95% CI: 140-510); and 0.48cm (95% CI: 0.45-0.52) and 0.33cm (95% CI: 0.27-0.40). The area under the ROC curve of FV and DVD were 0.926 and 0.766, respectively.</p></sec><sec><title>CONCLUSION:</title><p> the accuracy of the measured volume flow measured at the draining vein to evaluate maturation of hemodialysis arteriovenous fistula was 85%.</p></sec>

Skin perfusion pressure for predicting access-related hand ischemia following arteriovenous fistula surgery based on the brachial artery

2021 ◽  
pp. 112972982199398
Author(s):  
Miju Bae ◽  
Sung Woon Chung ◽  
Chung Won Lee ◽  
Up Huh ◽  
Moran Jin ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Sensitivity And Specificity ◽  
Brachial Artery ◽  
Perfusion Pressure ◽  
Characteristic Curve ◽  
Major Complication ◽  
Clinical Predictors ◽  
Skin Perfusion ◽  
Hand Ischemia ◽  
Skin Perfusion Pressure

Background: Access-related hand ischemia (ARHI) is a major complication of arteriovenous fistula (AVF). This study aimed to assess the predictive efficacy of skin perfusion pressure (SPP) measurement for ARHI by examining the relationship between SPP and ARHI development and progression after AVF surgery. Methods: Twenty-five patients (16 men and 9 women) who underwent AVF surgery based on the brachial artery between January 2018 and December 2018 were included. The pre- and postoperative SPP values were measured on the day of surgery. ARHI occurrence and severity were measured within 3 days and at 6 months after surgery. Receiver operating characteristic curve analysis was used to evaluate the prediction model of ARHI, and the cutoff points for the calculated coefficients were determined. Results: There was a significant correlation between the occurrence of immediate ARHI and the SPP gradient ( p = 0.024). An SPP gradient value >50 mmHg had sensitivity and specificity values of 53.85% and 91.67%, respectively, in predicting the occurrence of immediate ARHI. A postoperative SPP <48 mmHg was significantly correlated with the occurrence of 6-month ARHI ( p = 0.005), with sensitivity and specificity values of 71.43% and 83.33%, respectively. Conclusion: The SPP gradient and postoperative SPP values may be effective clinical predictors of ARHI occurring immediately and 6 months after surgery, respectively, with high specificity. These findings could allow clinicians to diagnose and begin early interventions to help prevent ischemic tissue damage in hemodialysis patients following AVF surgery.

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