Brachial artery blood flow measurement: A simple and noninvasive method to evaluate the need for arteriovenous fistula repair

OBJECTIVE

The objective of this study was to evaluate the utility of brachial artery blood flow measurement in assessing the need for arteriovenous fistula (AVF) repair.

METHODS

In 236 hemodialysis patients, the relationships between the brachial artery blood flow measurement results and subsequent AVF repair and prognosis were investigated.

RESULTS

Mean brachial artery blood flow was significantly lower in patients requiring percutaneous transluminal angioplasty (PTA; treatment group, n = 161) than in patients followed without any treatment (no treatment group, n = 64; 250.3 mL/min versus 656.7 mL/min, p < 0.0001). When the relationship between the mean brachial artery blood flow and PTA requirement was analyzed using the ROC curve, the optimal cut-off value with high sensitivity (true-positive fraction [TPF]) and 1-specificity (false-positive fraction [FPF]) was 348.8 mL/min (area under the ROC curve = 0.814, FPF = 0.125, TPF = 0.87).

CONCLUSIONS

Decreased brachial artery blood flow of <350 mL/min is associated with the need for subsequent AVF repair, suggesting that this simple and noninvasive method could be used to evaluate vascular access (VA) patency and indication for AVF repair.