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DOES BRACHIAL AND RADIAL ARTERY DIAMETERS INFLUENCE BLOOD FLOW THROUGH ARTERIOVENOUS FISTULA?

INTRODUCTION: Brachial artery volume flow (VF) estimated by Duplex sonography remains simple and reliable non-invasive technique to evaluate arteriovenous fistula (AVF) function. It is performed routinely to monitor and maintain good vascular access and timely intervention . The aim of this study was to evaluate whether brachial (AB) and radial artery (AR) diameter and their ratio influence volume flow in chronic dialysis patients.

METHODS: This cross-sectional study was developed in 70 patients (37 men, mean age 60±14 years) receiving chronic haemodialysis in Clinical Hospital Centre Zemun, Belgrade, Serbia. Patients were divided into three groups depending on AV anastomosis (I: distal radiocephalic-45 patients; II: proximal - 20 patients and III: brachiobasilic fistula - five patients). Duplex sonography was performed to evaluate diameters of radial and brachial artery and brachial artery volume flow.

RESULTS: Diameter of AR and AB were 4.26±1.04 and 5.63±1.12 mm, respectively; while mean VF 1057±506 ml/min. AB diameter and VF demonstrated a high degree of corellation (p=0.001). VF was higher in patients with AB diameter ≥ 5.0 mm (1153±549 ml/min) compared to AB diameter < 5.0 mm (846±308 ml/min; p=0.023). Radial artery diameter did not correlate with VF. Ratio between AR and AB diameters showed no corelation with access VF measurments. Flow was 988±461 ml/min in group I, 1023±380 ml/min and 1415±480 ml/min, in group II and III, respectively. Significant difference in flow was observed between groups I and III (p=0.05), whereas no difference between groups I and II, and groups II and III.

CONCLUSIONS: Estimation of brachial artery diameter correlates with volume flow, allowing simple and fast evaluation of vascular access function. Brachial artery diameter of more than 5.0 mm is predictive for achieving better volume flow.