Computerised analysis of auscultatory sounds associated with vascular patency of haemodialysis access.
Vascular access for renal dialysis is a lifeline for about 120 000 individuals in the United States. Stethoscope auscultation of vascular sounds has some utility in the assessment of access patency, yet can be highly skill-dependent. The objective of the study was to identify acoustic parameters that are related to changes in vascular access patency. The underlying hypothesis is that stenoses of haemodialysis access vessels or grafts cause vascular sound changes that are detectable using computerised data acquisition and analysis. Eleven patients participated in the study. Their vascular sounds were recorded before and after angiography, which was accompanied by angioplasty in most patients. The sounds were acquired using two electronic stethoscopes and then digitised and analysed on a personal computer. Vessel stenosis changes were found to be associated with changes in acoustic amplitude and/or spectral energy distribution. Certain acoustic parameters correlated well (correlation coefficient = 0.98, p < 0.0001) with the change in the degree of stenosis, suggesting that stenosis severity may be predictable from these parameters. Parameters also appeared to be sensitive to modest diameter changes (> 20%), (p < 0.005, Wilcoxon rank sum test). These results suggest that computerised analysis of vascular sounds may be useful in vessel patency surveillance. Further testing using longitudinal studies may be warranted.
Mansy
H A
HA
Biomedical Acoustics Research Group, Department of Pediatrics, Rush Medical College, Chicago, USA. hmansy@rush.edu
Hoxie
S J
SJ
Patel
N H
NH
Sandler
R H
RH
D001166:Arteriovenous Shunt, Surgical; D001314:Auscultation / Q000379:methods*; D001807:Blood Vessel Prosthesis; D005260:Female; D006083:Graft Occlusion, Vascular / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012815:Signal Processing, Computer-Assisted; D014654:Vascular Patency
J Biomech. 1976;9(10):633-40
965415
Chest. 1993 Nov;104(5):1518-25
8222817
IEEE Trans Biomed Eng. 1992 Feb;39(2):176-84
1612621
Surgery. 1983 Sep;94(3):464-70
6612581
IEEE Trans Med Imaging. 1998 Dec;17(6):900-9
10048847
Am J Kidney Dis. 1997 Oct;30(4 Suppl 3):S150-91
9339150
Med Biol Eng Comput. 2002 Sep;40(5):526-32
12452412
Kidney Int. 1990 Aug;38(2):337-41
2402125
J Vasc Surg. 1997 Dec;26(6):1009-19
9423717
Med Biol Eng Comput. 1995 Sep;33(5):669-75
8523908
Am J Surg. 1995 Sep;170(3):238-42
7661289
Am J Kidney Dis. 2003 Aug;42(2):331-41
12900816
Ann Surg. 1985 Aug;202(2):235-9
4015229
Ann Biomed Eng. 1994 Sep-Oct;22(5):493-500
7825751
Nephrol Dial Transplant. 1990;5(8):608-11
23281575
IEEE Trans Biomed Eng. 1990 Nov;37(11):1087-94
2276756
Kidney Int. 1995 May;47(5):1364-73
7637266
J Biomech. 1977;10(7):431-41
885895
J Acoust Soc Am. 1977 Apr;61(4):1077-85
864097
Kidney Int. 1997 Oct;52(4):1084-8
9328949
Stroke. 1994 Feb;25(2):397-402
8303751