Ultrasound guided puncture of the brachial artery for haemodialysis fistula angiography

Abstract

Fistula is critical because dialysis patient treatment depends on its function. Amongst the various methods Background. Arterio-venous (a-v) fistulae of haemo- dialysis patients frequently require function assessment for assessing fistula patency, angiography remains the gold standard for access evaluation (2). by angiography. The purpose of the present study was to determine the efficacy and safety of ultrasound- We are aware of no previous reports describing ultrasound-guided transbrachial catheterization for guided transbrachial catheterization when a-v fistulae were evaluated. dialysis fistula angiography. The purpose of this study was to assess the efficacy and complications of this Methods. Between July 1996 and December 1997, 208 dialysis patients, whose a-v fistulae (arterial inflow technique. 150 mm Hg in three consecutive HD sessions) were at the wrist or elbow, Subjects and methods underwent transbrachial angiography using an ultra- sound-guided 20-gauge IA needle to evaluate fistula From July 1996 to December 1997, 208 dialysis patients function. Procedure-related symptoms or complica- whose dysfunctional (arterial inflow 150 mmHg in three consecutive HD sessions) Results. No apparent cases of vessel spasm or throm- dialysis fistulae had been made at the elbow or wrist under- bosis were noted. Reported symptoms in 28 patients went transbrachial arteriography for fistula evaluation using (13.5%) included local arm pain (3.3%), transient ultrasound-guided catheterization. The 208 cases comprised paresthesia (0.9%), mild ecchymosis (10.6%) and 176 cases with radial artery to cephalic vein fistulae at the wrist, 12 cases with brachial artery to antecubital vein fistulae, haematoma (0.9%). All complications were minor and