Ultrasound measurement of brachial artery elasticity prior to hemodialysis access placement: A pilot study

Anna G. Sorace, Michelle L. Robbin, Heidi Umphrey, Carl A. Abts, Joel L. Berry, Mark E. Lockhart, Michael Allon, Kenneth Hoyt

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objectives-Successful hemodialysis requires reliable vascular access that can deliver adequate blood flow. An arteriovenous fistula is preferred for access because of its longevity and low frequency of complications, but up to 60% of arteriovenous fistulas created surgically are never suitable for hemodialysis because of nonmaturation (insufficient vascular dilatation). Decreased arterial elasticity may impair dilatation, thereby affecting fistula maturation. This study evaluated the feasibility of brachial artery elasticity measurement in patients with chronic kidney disease obtained during routine preoperative mapping ultrasound (US) imaging before hemodialysis access placement and compared the measurements to those obtained in healthy volunteers. Methods-Brachial artery functional US studies were collected from 75 patients undergoing routine preoperative mapping for hemodialysis access and 50 healthy volunteers. Vascular strain was calculated from the change in intima-media thickness between end systole and end diastole, and vascular stress was estimated from the pulse pressure. Assuming a linear elastic medium, the elastic modulus was estimated as the ratio of vascular stress to strain. Results-Elastic modulus measurements were significantly higher in patients than in volunteers (130 versus 100 kPa; P = .01). With combined volunteer and patient data, there was a significant correlation between elasticity and systolic blood pressure (R2 = 0.23; P < .001). Elasticity was correlated with age in volunteers but not in patients (R2 = 0.14; P = .017; R 2 < .001; P = .829, respectively). Conclusions-This analysis of clinical arterial vessel biomechanics shows that a noninvasive US measurement can detect elastic modulus differences between patients with chronic kidney disease and healthy individuals. Future studies will correlate the elastic modulus with histologic characteristics and eventual arteriovenous fistula maturation, which may provide supplemental information on arterial biomechanical properties as a useful addition to current predictors of fistula success.

Original languageEnglish (US)
Pages (from-to)1581-1588
Number of pages8
JournalJournal of Ultrasound in Medicine
Volume31
Issue number10
StatePublished - Oct 1 2012

Fingerprint

Brachial Artery
Elasticity
Renal Dialysis
Elastic Modulus
Blood Vessels
Arteriovenous Fistula
Volunteers
Blood Pressure
Chronic Renal Insufficiency
Fistula
Dilatation
Healthy Volunteers
Diastole
Systole
Feasibility Studies
Biomechanical Phenomena
Ultrasonography

Keywords

  • Chronic kidney disease
  • Elastic modulus
  • Strain
  • Stress
  • Ultrasound

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

Cite this

Sorace, A. G., Robbin, M. L., Umphrey, H., Abts, C. A., Berry, J. L., Lockhart, M. E., ... Hoyt, K. (2012). Ultrasound measurement of brachial artery elasticity prior to hemodialysis access placement: A pilot study. Journal of Ultrasound in Medicine, 31(10), 1581-1588.

Ultrasound measurement of brachial artery elasticity prior to hemodialysis access placement : A pilot study. / Sorace, Anna G.; Robbin, Michelle L.; Umphrey, Heidi; Abts, Carl A.; Berry, Joel L.; Lockhart, Mark E.; Allon, Michael; Hoyt, Kenneth.

In: Journal of Ultrasound in Medicine, Vol. 31, No. 10, 01.10.2012, p. 1581-1588.

Research output: Contribution to journalArticle

Sorace, AG, Robbin, ML, Umphrey, H, Abts, CA, Berry, JL, Lockhart, ME, Allon, M & Hoyt, K 2012, 'Ultrasound measurement of brachial artery elasticity prior to hemodialysis access placement: A pilot study', Journal of Ultrasound in Medicine, vol. 31, no. 10, pp. 1581-1588.
Sorace AG, Robbin ML, Umphrey H, Abts CA, Berry JL, Lockhart ME et al. Ultrasound measurement of brachial artery elasticity prior to hemodialysis access placement: A pilot study. Journal of Ultrasound in Medicine. 2012 Oct 1;31(10):1581-1588.
Sorace, Anna G. ; Robbin, Michelle L. ; Umphrey, Heidi ; Abts, Carl A. ; Berry, Joel L. ; Lockhart, Mark E. ; Allon, Michael ; Hoyt, Kenneth. / Ultrasound measurement of brachial artery elasticity prior to hemodialysis access placement : A pilot study. In: Journal of Ultrasound in Medicine. 2012 ; Vol. 31, No. 10. pp. 1581-1588.
@article{9fdf72b006544d3f8b01983bb42710ae,
title = "Ultrasound measurement of brachial artery elasticity prior to hemodialysis access placement: A pilot study",
abstract = "Objectives-Successful hemodialysis requires reliable vascular access that can deliver adequate blood flow. An arteriovenous fistula is preferred for access because of its longevity and low frequency of complications, but up to 60{\%} of arteriovenous fistulas created surgically are never suitable for hemodialysis because of nonmaturation (insufficient vascular dilatation). Decreased arterial elasticity may impair dilatation, thereby affecting fistula maturation. This study evaluated the feasibility of brachial artery elasticity measurement in patients with chronic kidney disease obtained during routine preoperative mapping ultrasound (US) imaging before hemodialysis access placement and compared the measurements to those obtained in healthy volunteers. Methods-Brachial artery functional US studies were collected from 75 patients undergoing routine preoperative mapping for hemodialysis access and 50 healthy volunteers. Vascular strain was calculated from the change in intima-media thickness between end systole and end diastole, and vascular stress was estimated from the pulse pressure. Assuming a linear elastic medium, the elastic modulus was estimated as the ratio of vascular stress to strain. Results-Elastic modulus measurements were significantly higher in patients than in volunteers (130 versus 100 kPa; P = .01). With combined volunteer and patient data, there was a significant correlation between elasticity and systolic blood pressure (R2 = 0.23; P < .001). Elasticity was correlated with age in volunteers but not in patients (R2 = 0.14; P = .017; R 2 < .001; P = .829, respectively). Conclusions-This analysis of clinical arterial vessel biomechanics shows that a noninvasive US measurement can detect elastic modulus differences between patients with chronic kidney disease and healthy individuals. Future studies will correlate the elastic modulus with histologic characteristics and eventual arteriovenous fistula maturation, which may provide supplemental information on arterial biomechanical properties as a useful addition to current predictors of fistula success.",
keywords = "Chronic kidney disease, Elastic modulus, Strain, Stress, Ultrasound",
author = "Sorace, {Anna G.} and Robbin, {Michelle L.} and Heidi Umphrey and Abts, {Carl A.} and Berry, {Joel L.} and Lockhart, {Mark E.} and Michael Allon and Kenneth Hoyt",
year = "2012",
month = "10",
day = "1",
language = "English (US)",
volume = "31",
pages = "1581--1588",
journal = "Journal of Ultrasound in Medicine",
issn = "0278-4297",
publisher = "American Institute of Ultrasound in Medicine",
number = "10",

}

TY - JOUR

T1 - Ultrasound measurement of brachial artery elasticity prior to hemodialysis access placement

T2 - A pilot study

AU - Sorace, Anna G.

AU - Robbin, Michelle L.

AU - Umphrey, Heidi

AU - Abts, Carl A.

AU - Berry, Joel L.

AU - Lockhart, Mark E.

AU - Allon, Michael

AU - Hoyt, Kenneth

PY - 2012/10/1

Y1 - 2012/10/1

N2 - Objectives-Successful hemodialysis requires reliable vascular access that can deliver adequate blood flow. An arteriovenous fistula is preferred for access because of its longevity and low frequency of complications, but up to 60% of arteriovenous fistulas created surgically are never suitable for hemodialysis because of nonmaturation (insufficient vascular dilatation). Decreased arterial elasticity may impair dilatation, thereby affecting fistula maturation. This study evaluated the feasibility of brachial artery elasticity measurement in patients with chronic kidney disease obtained during routine preoperative mapping ultrasound (US) imaging before hemodialysis access placement and compared the measurements to those obtained in healthy volunteers. Methods-Brachial artery functional US studies were collected from 75 patients undergoing routine preoperative mapping for hemodialysis access and 50 healthy volunteers. Vascular strain was calculated from the change in intima-media thickness between end systole and end diastole, and vascular stress was estimated from the pulse pressure. Assuming a linear elastic medium, the elastic modulus was estimated as the ratio of vascular stress to strain. Results-Elastic modulus measurements were significantly higher in patients than in volunteers (130 versus 100 kPa; P = .01). With combined volunteer and patient data, there was a significant correlation between elasticity and systolic blood pressure (R2 = 0.23; P < .001). Elasticity was correlated with age in volunteers but not in patients (R2 = 0.14; P = .017; R 2 < .001; P = .829, respectively). Conclusions-This analysis of clinical arterial vessel biomechanics shows that a noninvasive US measurement can detect elastic modulus differences between patients with chronic kidney disease and healthy individuals. Future studies will correlate the elastic modulus with histologic characteristics and eventual arteriovenous fistula maturation, which may provide supplemental information on arterial biomechanical properties as a useful addition to current predictors of fistula success.

AB - Objectives-Successful hemodialysis requires reliable vascular access that can deliver adequate blood flow. An arteriovenous fistula is preferred for access because of its longevity and low frequency of complications, but up to 60% of arteriovenous fistulas created surgically are never suitable for hemodialysis because of nonmaturation (insufficient vascular dilatation). Decreased arterial elasticity may impair dilatation, thereby affecting fistula maturation. This study evaluated the feasibility of brachial artery elasticity measurement in patients with chronic kidney disease obtained during routine preoperative mapping ultrasound (US) imaging before hemodialysis access placement and compared the measurements to those obtained in healthy volunteers. Methods-Brachial artery functional US studies were collected from 75 patients undergoing routine preoperative mapping for hemodialysis access and 50 healthy volunteers. Vascular strain was calculated from the change in intima-media thickness between end systole and end diastole, and vascular stress was estimated from the pulse pressure. Assuming a linear elastic medium, the elastic modulus was estimated as the ratio of vascular stress to strain. Results-Elastic modulus measurements were significantly higher in patients than in volunteers (130 versus 100 kPa; P = .01). With combined volunteer and patient data, there was a significant correlation between elasticity and systolic blood pressure (R2 = 0.23; P < .001). Elasticity was correlated with age in volunteers but not in patients (R2 = 0.14; P = .017; R 2 < .001; P = .829, respectively). Conclusions-This analysis of clinical arterial vessel biomechanics shows that a noninvasive US measurement can detect elastic modulus differences between patients with chronic kidney disease and healthy individuals. Future studies will correlate the elastic modulus with histologic characteristics and eventual arteriovenous fistula maturation, which may provide supplemental information on arterial biomechanical properties as a useful addition to current predictors of fistula success.

KW - Chronic kidney disease

KW - Elastic modulus

KW - Strain

KW - Stress

KW - Ultrasound

UR - http://www.scopus.com/inward/record.url?scp=84867216420&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84867216420&partnerID=8YFLogxK

M3 - Article

C2 - 23011621

AN - SCOPUS:84867216420

VL - 31

SP - 1581

EP - 1588

JO - Journal of Ultrasound in Medicine

JF - Journal of Ultrasound in Medicine

SN - 0278-4297

IS - 10

ER -