Ultrasound guided puncture of the brachial artery for haemodialysis fistula angiography.
BACKGROUND
Arterio-venous (a-v) fistulae of haemodialysis patients frequently require function assessment by angiography. The purpose of the present study was to determine the efficacy and safety of ultrasound-guided transbrachial catheterization when a-v fistulae were evaluated.


METHODS
Between July 1996 and December 1997, 208 dialysis patients, whose a-v fistulae (arterial inflow < 50 ml/min or venous pressure > 150 mm Hg in three consecutive HD sessions) were at the wrist or elbow, underwent transbrachial angiography using an ultrasound-guided 20-gauge IA needle to evaluate fistula function. Procedure-related symptoms or complications were noted in 28 patients and these were analysed.


RESULTS
No apparent cases of vessel spasm or thrombosis were noted. Reported symptoms in 28 patients (13.5%) included local arm pain (3.3%), transient paresthesia (0.9%), mild ecchymosis (10.6%) and haematoma (0.9%). All complications were minor and none required surgical intervention.


CONCLUSIONS
Ultrasound-guided puncture of the brachial artery is a safe, reliable and effective procedure in skilled hands and should be the preferred means of catheterization whenever haemodialysis angiography is performed.
Lui
K W
KW
First Department of Diagnostic Radiology, Chang Gung Medical Center at Linkou, College of Medicine, Chang Gung University, Taiwan.
Yeow
K M
KM
Wan
Y L
YL
Cheung
Y C
YC
Ng
K K
KK
Tseng
J H
JH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000009:adverse effects / Q000379:methods*; D001166:Arteriovenous Shunt, Surgical; D001916:Brachial Artery / Q000000981:diagnostic imaging* / Q000502:physiology; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011677:Punctures; D006435:Renal Dialysis; D012449:Safety; D014463:Ultrasonography