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Ultrasound assessment of upper limb arteriovenous fistulas in hemodialysis patients at the Yaounde University Teaching Hospital

Harvey Onana Atanga

Harvey Onana Atanga

Radiology Unit, Ngaoundere Regional HospitalNgaoundere, Cameroon
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Atanga, Harvey Onana
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Ambroise Seme

Ambroise Seme

Radiology and Radiation Oncology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1Yaoundé, Cameroon
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Maimouna Mahamat

Maimouna Mahamat

Internal Medicine and Subspecialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1Yaoundé, Cameroon
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Mahamat, Maimouna
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Yannick Onana

Yannick Onana

Radiology, Faculty of Medicine and Biomedical Sciences, University of GarouaGaroua, Cameroon
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Onana, Yannick
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Emilienne Guegang

Emilienne Guegang

Radiology and Radiation Oncology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1Yaoundé, Cameroon
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Guegang, Emilienne
  
30 nov 2024
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Categoria dell'articolo: Research Paper
Pubblicato online: 30 nov 2024
Pagine: 1 - 5
Ricevuto: 18 dic 2023
Accettato: 11 apr 2024
DOI: https://doi.org/10.15557/jou.2024.0028
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© 2024 Harvey Onana Atanga1 et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Fig. 1.

Image showing a transverse section through an aneurysm
Image showing a transverse section through an aneurysm

Fig. 2.

Measurement of flow volume within the efferent vein
Measurement of flow volume within the efferent vein

Clinical characteristics of study population

Characteristic N = 41 mean (SD), median Frequency (%)
Sex: male 23 56.1
Mean age 48.39 (16.56)
Comorbidities Hypertension 34 82.9
Diabetes 11 26.6
Smoking 3 7.3
Obesity 3 7.3
HIV 5 12.2
Number of prior fistulas (0 : 1) (32 : 9) 78 : 22
Mean weight (SD), kg 69.67 (13.85)
Mean BMI (SD), kg/m2 24.60 (4.21)
Median dialysis vintage (IQR), months 16.00 (8–32)
Mean dialysis vintage (SD), months 23.60 (22.40)
Mean AVF age (SD), months 20.25 (18.62)
Fistula type Radiocephalic 31 75.6
Brachiocephalic 10 24.4

Hemodynamic characteristics

Characteristic N = 41, frequency (%)
Mean artery PSV (SD), cm/s 131.26 (51.98)
Mean RI (SD) 0.43 (0.08)
RI <0.5 37 (90.2%)
Mean anastomosis PSV (SD), cm/s 248.29 (103.81)
Mean flow volume (SD), ml/min 680.47 (365.98)
Low flow volume 14 (34.1%)

Univariate analysis of factors associated with low flow volume

Low flow volume p
Yes (n = 14) No (n = 27)
Male 9 (64.3%) 14 (51.9%) 0.447
Mean age (SD) 55.14 (16.61) 44.89 (15.71) 0.059
Mean BMI (SD) 25.30 (4.15) 24.35 (4.27) 0.468
No prior fistula on limb 12 (85.7%) 20 (74.1%) 0.692
Radiocephalic AVF 11 (78.6%) 20 (74.1%) 1.000
Diabetes 8 (57.1%) 3 (11.1%) 0.003
Hypertension 12 (85.7%) 22 (81.5%) 1.000
HIV 0 (0%) 5 (18.5%) 0.146
Mean dialysis vintage (SD), months 19.64 (18.23) 25.67 (24.35) 0.421
Mean AVF age (SD), months 14.08 (9.08) 23.22 (21.30) 0.148
Mean RI (SD) 0.44 (0.08) 0.42 (0.03) 0.557
Reverse flow 5 (35.7%) 14 (51.9%) 0.616
Aneurysm 4 (28.6%) 18 (66.7%) 0.026
Venous luminal flaps 0 (0%) 9 (33.3%) 0.013
Thrombosis 1 (7.1%) 6 (22.2%) 0.389
Stenosis 9 (64.3%) 14 (51.9%) 0.447

Prevalence of vascular modifications

N = 41, frequency (%)
Stenosed fistulas 23 (56.1)
Stenosis criteria Ratio >PSV 3 : 1 6 (14.6)
PSV >375 cm/s 18 (43.9)
Ratio >Diameter 2 : 1 3 (7.3)
Aneurysm 22 (53.7)
Reverse flow 21 (51.2)
Venous luminal flaps 9 (22)
Thrombosis 7 (17.1)
Venous wall calcifications 2 (4.9)
Perivascular hematoma 1 (2.4)
AVFs with vascular abnormality 32 (78.05)
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