Korean J Nephrol.  2007 Jan;26(1):70-78.

Early Detection of Hemodialysis Arteriovenous Fistula Dysfunction with Intra-access Static and Total Pressure Measurement

• Lee JH
• Park SI
• Yoon SY
• Lee SC
• Yang SJ
• Ahn HJ
• Kim YS
• Park K

Abstract

PURPOSE: To detect the dysfunction of arteriovenous fistula (AVF) early, we have developed a new method to calculate the intra-vascular conduit flow rate based on the Bernoulli's theory. However, this method has limitation on detection of inflow stenosis. For detection of both in- and out-flow stenosis, we tried to measure intra-access static (pS) and total pressure (pT), and compared with angiographic findings.
METHODS
From a total of 46 cases of native AVFs, of at least 3 months of construction, intra-access pS and pT were measured, before starting hemodialysis. deltap (pT-pS) and pT/mean arterial pressure (MAP) ratio were calculated, and compared with angiographic findings.
RESULTS
Among 37 patients without outflow stenosis (Vs) in fistulogram, 10 patients with inflow stenosis (As) had significantly lower pT/MAP ratio and deltap than those without As patients (p<0.005). Among 34 patients without As, deltap was significantly lower in 7 patients with Vs than those 27 patients without Vs (p=0.001).
CONCLUSION
pT/MAP ratio was correlated with As, and deltap reflects Vs in angiography. The measurement of pS and pT might be useful to predict inflow and outflow stenosis of AVFs.

Keyword

Arteriovenous fistula; Stenosis; Pressure; Angiography

MeSH Terms

Angiography
Arterial Pressure
Arteriovenous Fistula*
Constriction, Pathologic
Humans
Renal Dialysis*