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KMID : 0359920070260010070
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Korean Journal of Nephrology
2007 Volume.26 No. 1 p.70 ~ p.78
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Early Detection of Hemodialysis Arteriovenous Fistula Dysfunction with Intra-access Static and Total Pressure Measurement
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Lee Jong-Hoon
Park Sung-Il
Yoon Soo-Young
Lee Sang-Choel
Yang Sung-Ja
Ahn Hyung-Joon
Kim Yu-Seun
Park Ki-Il
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Abstract
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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. Δp (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 Δp than those without As patients (p<0.005). Among 34 patients without As, Δp 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 Δp reflects Vs in angiography. The measurement of pS and pT might be useful to predict inflow and outflow stenosis of AVFs.
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KEYWORD
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Arteriovenous fistula, Stenosis, Pressur, Angiography
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