Barry Belmont1, Dae Woo Park2, Albert Shih1,3, Matthew Leavitt4, Brett Plattner4, Peter K Henke4,5, William F Weitzel4,5. 1. 1 Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA. 2. 2 Innovative Medical Engineering & Technology, National Cancer Center, Goyang, Korea. 3. 3 Mechanical Engineering, University of Michigan, Ann Arbor, MI, USA. 4. 4 Internal Medicine, University of Michigan, Ann Arbor, MI, USA. 5. 5 Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA.
Abstract
PURPOSE: : Autogenous arteriovenous fistulas are the preferred access for hemodialysis. Yet when created, fistulas often fail to mature, requiring surgical or radiologic interventions before their use. This pilot study measures the vascular wall elasticity and flow gradient using an open-source ultrasound software program designed to aid in assessing fistula maturation. METHODS: : A total of seven end-stage renal disease patients were enrolled for our study after providing informed consent. Ultrasound scanning was performed for the inflow artery, post-arterial anastomotic segment, and outflow vein at initial and follow-up evaluation. Conventional digital imaging and communications in medicine data were collected from the ultrasound machine. The vessel diameter and distensibility of artery, post-arterial anastomotic segment, and vein were computed from the digital imaging and communications in medicine data using an open-source ultrasound software program. RESULTS: : The vessel diameter of artery and vein increased from 4.6 ± 1.1 mm to 6.0 ± 1.1 mm and from 5.8 ± 0.7 mm to 7.5 ± 0.9 mm from 1 to 6 weeks post-operation, respectively. Conversely, the vessel diameter of post-arterial anastomotic segment decreased from 4.2 ± 1.0 mm to 3.5 ± 0.9 mm from 1 to 6 weeks post-operation. The distensibility of artery and post-arterial anastomotic segment increased from 3.4% ± 0% to 5.9% ± 1.1% and 3.7% ± 1.2% to 4.9% ± 1.4%, respectively, while the distensibility of vein decreased from 5.0% ± 1.3% to 2.6% ± 0.4% from 1 to 6 weeks post-operation. CONCLUSION: : This study demonstrates that the change in vessel diameter and distensibility related to the healthy remodeling as the vein dilates during maturation.
PURPOSE: : Autogenous arteriovenous fistulas are the preferred access for hemodialysis. Yet when created, fistulas often fail to mature, requiring surgical or radiologic interventions before their use. This pilot study measures the vascular wall elasticity and flow gradient using an open-source ultrasound software program designed to aid in assessing fistula maturation. METHODS: : A total of seven end-stage renal diseasepatients were enrolled for our study after providing informed consent. Ultrasound scanning was performed for the inflow artery, post-arterial anastomotic segment, and outflow vein at initial and follow-up evaluation. Conventional digital imaging and communications in medicine data were collected from the ultrasound machine. The vessel diameter and distensibility of artery, post-arterial anastomotic segment, and vein were computed from the digital imaging and communications in medicine data using an open-source ultrasound software program. RESULTS: : The vessel diameter of artery and vein increased from 4.6 ± 1.1 mm to 6.0 ± 1.1 mm and from 5.8 ± 0.7 mm to 7.5 ± 0.9 mm from 1 to 6 weeks post-operation, respectively. Conversely, the vessel diameter of post-arterial anastomotic segment decreased from 4.2 ± 1.0 mm to 3.5 ± 0.9 mm from 1 to 6 weeks post-operation. The distensibility of artery and post-arterial anastomotic segment increased from 3.4% ± 0% to 5.9% ± 1.1% and 3.7% ± 1.2% to 4.9% ± 1.4%, respectively, while the distensibility of vein decreased from 5.0% ± 1.3% to 2.6% ± 0.4% from 1 to 6 weeks post-operation. CONCLUSION: : This study demonstrates that the change in vessel diameter and distensibility related to the healthy remodeling as the vein dilates during maturation.
Authors: Yihao Zheng; Brian J Thelen; Nirmala Rajaram; Venkataramu N Krishnamurthy; James Hamilton; Miguel Angel Funes-Lora; Timothy Morgan; Lenar Yessayan; Brandie Bishop; Nickolas Osborne; Peter Henke; Albert J Shih; William F Weitzel Journal: Ann Biomed Eng Date: 2021-08-11 Impact factor: 3.934