Hemodynamic changes in the cephalic vein of patients with hemodialysis arteriovenous fistula

Purpose. To assess via Doppler sonography the hemodynamic changes in the cephalic vein after creation of an arteriovenous fistula, and to compare radiocephalic and brachiocephalic fistulas. Methods. Thirty‐three hemodialysis patients and 54 controls were enrolled in the study. The cephalic vein was...

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Bibliographic Details
Published in:Journal of clinical ultrasound 2007-03, Vol.35 (3), p.133-137
Main Authors: Albayrak, Ramazan, Yuksel, Seref, Colbay, Mehmet, Degirmenci, Bumin, Acarturk, Gursel, Haktanır, Alpay, Karaman, Ozcan
Format: Article
Language:English
Subjects:
Adult
Aged
arteriovenous fistula
Arteriovenous Shunt, Surgical
Blood Flow Velocity
Brachial Artery - diagnostic imaging
Brachial Artery - physiopathology
Brachiocephalic Veins - diagnostic imaging
Brachiocephalic Veins - physiopathology
Case-Control Studies
cephalic vein
chronic hemodialysis
Diastole
Doppler ultrasonography
Female
Forearm - blood supply
Humans
Kidney Failure, Chronic - therapy
Male
Middle Aged
Pulsatile Flow
Radial Artery - diagnostic imaging
Radial Artery - physiopathology
Regional Blood Flow
Renal Dialysis - adverse effects
Systole
Ultrasonography, Doppler
Vascular Resistance
venous access
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Summary:Purpose. To assess via Doppler sonography the hemodynamic changes in the cephalic vein after creation of an arteriovenous fistula, and to compare radiocephalic and brachiocephalic fistulas. Methods. Thirty‐three hemodialysis patients and 54 controls were enrolled in the study. The cephalic vein was examined with a 7.5‐MHz linear‐array transducer. Doppler waveform parameters (resistance index, pulsatility index), time‐averaged maximum flow velocity (TAV), peak systolic velocity (PSV), end‐diastolic velocity (EDV), and the cross‐sectional area of the vessel (A) were measured. Cephalic vein flow volume (CVFV) was calculated as TAV × A. Results. CVFV, PSV, EDV, A, RI, and PI were 45.5, 7.2, 6.7, 7.7, 1.2, and 1.32 times higher, respectively, in the cephalic vein of hemodialysis patients compared with controls. Both CVFV and A were higher in brachiocephalic patients compared with radiocephalic patients (1,983 ± 1,199 versus 870 ± 322 ml/min [p < 0.05] and 50.3 ± 38.9 versus 21.0 ± 7.8 mm2 [p < 0.05], respectively). Conclusion. The increase in cross‐sectional area and flow volume of the cephalic vein is larger in patients with brachiocephalic fistulas than in those with radiocephalic fistulas; however, flow velocities and waveform parameters are not different. © 2007 Wiley Periodicals, Inc. J Clin Ultrasound, 2007
ISSN:0091-2751
1097-0096
DOI:10.1002/jcu.20307