Detection of blood flow in the brachial artery and dialysis flow after standard internal fistula operation by ultrasound: an association study

Objective To explore the value of detection of blood flow in the brachial artery after forearm standard internal fistula (wrist radial artery-cephalic vein) operation by color Doppler ultrasound in the assessment of internal fistula function. Methods The data of the blood flow in the brachial artery after forearm standard internal fistula operation detected by color Doppler ultrasound in 103 patients were retrospectively studied. In detecting the blood flow in the brachial artery, 350 ml/min and 500 ml/min were used as demarcation points and the patients were divided into dysfunction, uncertainty and good function group. In internal fistula dysfunction, dialysis flow <200 ml/min was taken as the golden criterion. ROC curve was constructed and analyzed. Results In using Doppler ultrasound to detect the blood flow in the brachial artery and to diagnose the standard internal fistula dysfunction, the area under ROC curve was 0.949 (P<0.001) and 95% of confidence interval was (0.909, 0.989). The best diagnostic demarcation point was 470 ml/min. In using the blood flow 350 ml/min and 500 ml/min in the brachial artery as demarcation points and dividing the patients into dysfunction, uncertainty and good function group, the area under the ROC curve was 0.916 (P<0.001) and 95% of confidence interval was (0.857, 0.975). Conclusions The accuracy of using Doppler ultrasound to detect the blood flow in the brachial artery and to diagnose the standard internal fistula dysfunction is higher. Using 350 ml/min and 500 ml/min as demarcation points, the grouping method is of higher clinical applied value. Key words: Ultrasonography; Renal dialysis; Internal arteriovenous fistula; Brachial artery; Hemodynamics