The relationship between post-anastomosis brachial artery flow rate and brachiocephalic arteriovenous fistula access maturity in end-stage kidney disease patients with diabetes mellitus.

IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Ultrasound Pub Date : 2024-10-27 DOI:10.1177/1742271X241287926
Dedy Pratama, Octavianus Wasisto, Aria Kekalih, Raden Suhartono, Akhmadu Muradi, Muhammad F Ferian, Avicenna Akbar
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Abstract

Background: From previous studies, evaluation of post-anastomosis draining-vein volume flow rate with Doppler ultrasound can be a predictor for arteriovenous fistula maturation. Due to the high variation in measurements by the effect of probe pressure in draining vein, measuring volume flow rate based on post-anastomosis feeding-artery may be an early alternative predictor of arteriovenous fistula maturation. This study aims to investigate the correlation of post-creation brachial artery volume flow rate on maturity of brachiocephalic arteriovenous fistula access in patients with end-stage kidney disease with diabetes mellitus.

Methods: A retrospective cohort study was conducted on end-stage kidney disease patients with diabetes mellitus who underwent brachiocephalic arteriovenous fistula creation at three hospitals from July 2019 to March 2020. Doppler ultrasound examination of the brachial artery and draining vein volume flow rate was conducted at pre-operative, post-creation, 2 weeks, and 6 weeks post-creation. Maturity was evaluated at 6 weeks post-anastomosis.

Results: A total of 71 subjects met the inclusion and exclusion criteria, with 44 (62%) achieving maturation within 6 weeks. There was a correlation between post-anastomosis brachial artery (p < 0.001) and draining vein volume flow rate (p < 0.001) with arteriovenous fistula maturity after 6 weeks post-operatively. Brachial artery volume flow rate of ⩾350 mL/min can predict AVF maturity with a sensitivity of 95.45% (95% confidence interval = 84.86-98.74) and a specificity of 85.19% (95% confidence interval = 67.52-94.08).

Conclusion: Post-anastomosis brachial artery flow volume can be a valuable parameter to predict brachiocephalic arteriovenous fistula maturity. It is a potential alternative to draining vein volume flow, which is technically a difficult examination.

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糖尿病终末期肾病患者吻合术后肱动脉流速与肱动脉动静脉瘘通路成熟度之间的关系。
背景:根据以往的研究,用多普勒超声评估吻合术后引流静脉的容积流速可作为动静脉瘘成熟的预测指标。由于受引流静脉内探头压力的影响,测量结果差异较大,因此根据吻合后的供血动脉测量容积流速可能是动静脉瘘成熟的早期替代预测指标。本研究旨在探讨糖尿病终末期肾病患者吻合后肱动脉容积流速与动静脉瘘通路成熟度的相关性:对2019年7月至2020年3月在三家医院接受肱动脉动静脉造瘘术的糖尿病终末期肾病患者进行回顾性队列研究。在术前、造瘘术后、造瘘术后 2 周和 6 周对肱动脉和引流静脉容积流量进行多普勒超声检查。吻合术后 6 周评估成熟度:共有 71 名受试者符合纳入和排除标准,其中 44 人(62%)在 6 周内达到成熟。吻合后的肱动脉(p < 0.001)和引流静脉容积流速(p < 0.001)与术后 6 周的动静脉瘘成熟度存在相关性。肱动脉容积流量⩾350 mL/min可预测动静脉瘘成熟度,敏感性为95.45%(95%置信区间=84.86-98.74),特异性为85.19%(95%置信区间=67.52-94.08):结论:吻合术后肱动脉血流量是预测肱脑动静脉瘘成熟度的重要参数。它是引流静脉血流量的潜在替代方法,而引流静脉血流量检查在技术上有一定难度。
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来源期刊
Ultrasound
Ultrasound RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
1.70
自引率
0.00%
发文量
55
期刊介绍: Ultrasound is the official journal of the British Medical Ultrasound Society (BMUS), a multidisciplinary, charitable society comprising radiologists, obstetricians, sonographers, physicists and veterinarians amongst others.
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