The value of duplex ultrasound in the prediction of brachial dialysis access induced ischemia syndrome (DAIIS).
OBJECTIVE
Dialysis access induced ischemia syndrome (DAIIS) is a serious complication of Vascular Access (VA) surgery. It mainly occurs in brachial VA. The aim of this prospective study was to ascertain whether early detection of DAIIS following brachial VA is possible, enabling immediate therapy.


METHODS
One hundred and three patients undergoing brachial VA-surgery were surveyed. Duplex ultrasound was performed before and directly after surgery and the flow amplitudes of the distal ulnar and radial arteries were measured. Clinical follow up was performed after two months. In addition, specific patient characteristics were assessed.


RESULTS
Sixteen patients (15.5%) developed DAIIS with the need for surgical intervention. Statistical analysis revealed a statistically significant correlation between post-operative flow amplitudes of the distal arteries measured by duplex ultrasound and the development of DAIIS.


CONCLUSIONS
According to our data, measurement of the flow-amplitudes of distal arteries by duplex ultrasound shortly after surgery predicts the development of DAIIS. This makes immediate therapy possible. We recommend early post-operative duplex-ultrasound investigation following the creation of a brachial VA.
Department of Vascular and Endovascular Surgery, Hospital St. Elisabeth and St. Barbara, Teaching Hospital of the Martin-Luther-University Halle-Wittenberg, Halle, Germany. f.thermann@krankenhaus-halle-saale.de
Florian
F
Thermann
Udo
U
Junge
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D001783:Blood Flow Velocity; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D042241:Early Diagnosis; D005260:Female; D005858:Germany; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D017534:Radial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D012039:Regional Blood Flow; D006435:Renal Dialysis; D013997:Time Factors; D017535:Ulnar Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D018616:Ultrasonography, Doppler, Duplex; D034941:Upper Extremity / Q000098:blood supply*