Racial and Gender Differences in Arterial Anatomy of the Arm

Prior studies have shown racial and gender differences with respect to maturation of arteriovenous fistulas. Women and minorities have lower maturation rates for unclear reasons. Small arterial diameter and high brachial artery bifurcation (HBB) are also implicated in reduced maturation rates. We so...

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Bibliographic Details
Published in:The American surgeon 2016-10, Vol.82 (10), p.973-976
Main Authors: Pham, Xuan-Binh D., Kim, Jerry J., Parrish, Aaron B., Tom, Cynthia, Ihenachor, Ezinne J., Mina, David, De Virgilio, Christian
Format: Article
Language:English
Subjects:
Adult
African Americans
Aged
Arm - anatomy & histology
Arm - blood supply
Arteries - anatomy & histology
Asian Continental Ancestry Group
Brachial Artery - anatomy & histology
Cardiovascular disease
Cohort Studies
Comparative analysis
Continental Population Groups
European Continental Ancestry Group
Expected values
Female
Females
Gender differences
Hemodialysis
Hispanic Americans
Hispanic people
Humans
Male
Middle Aged
Patients
Race
Radial Artery - anatomy & histology
Retrospective Studies
Risk factors
Sex Factors
Statistics, Nonparametric
Studies
Women
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Summary:Prior studies have shown racial and gender differences with respect to maturation of arteriovenous fistulas. Women and minorities have lower maturation rates for unclear reasons. Small arterial diameter and high brachial artery bifurcation (HBB) are also implicated in reduced maturation rates. We sought to correlate differences in upper extremity arterial anatomy to race and gender. All upper extremity vascular mapping ultrasounds from 2013 to 2014 were retrospectively reviewed. A total of 509 arms in 284 patients were evaluated. Men had significantly higher mean arterial diameters than women at the elbow brachial (4.7 vs 3.9 mm, P < 0.01) and wrist radial arteries (2.1 vs 1.9 mm, P = 0.03). There were 20 (7%) patients with HBB of at least one arm, and 7 (2.5%) patients with bilateral HBB. African-American patients had significantly higher rates of both unilateral HBB (15.9% vs 5.4%, P = 0.02) and bilateral HBBs (9.1% vs 1.3%, P = 0.01). In conclusion, men had significantly larger arteries than women, and African-Americans had a higher rate of HBB than non-African-Americans. Consideration should be given for routine preoperative ultrasound to assess arterial anatomy before arteriovenous fistulas creation, particularly in women and in African-Americans.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313481608201025