Application of ultrasonography in monitoring the complications of autologous arteriovenous fistula in hemodialysis patients

This study aims to evaluate the application of color Doppler ultrasound in monitoring the complications of autologous arteriovenous fistula in hemodialysis patients. Patients with maintenance hemodialysis who underwent autologous arteriovenous fistula were enrolled in this cross-sectional study. Ultrasound was used to detect fistula complications (stenosis and thrombosis), brachial artery diameter, and hemodynamic parameters. The ultrasound parameters were analyzed and screened to identify the most important indicator for monitoring complications. In all, 89 patients were included. Ultrasound showed 72 cases (80.90%) had normal fistula structure, and 17 cases (19.10%) had complications. The diameter, time-averaged mean velocity, flow volume, and diastolic peak velocity of brachial artery in complication group were significantly lower than those of noncomplication group (P<.05). The brachial artery pulsatility index and resistance index of complication group were significantly higher than those of noncomplication group (P<.05). There was no significant difference in peak flow velocity between complication and noncomplication group (P>.05). Indicators showed statistical significance were grouped based on quantiles. The incidence of complications was higher when the brachial artery diameter was <= 5.40mm, or brachial artery flow was <= 460mL/min, or brachial artery pulsatility index was >1.04, or brachial artery resistance index was >0.60. Ultrasound monitoring of brachial artery diameter and hemodynamic parameters can help early detection of fistula complications. When the brachial artery diameter was < 5.40mm, or brachial artery flow was <= 460mL/min, or brachial artery pulsatility index was >1.04, or brachial artery resistance index >0.60, stenosis or thrombosis should be checked to prevent fistula failure.