Does central venous stenosis affects the brachial artery flow volume and peripheral vascular resistive index in...

Area of Science:

• Nephrology
• Vascular Surgery
• Radiology

Background:

• Vascular access (VA) is critical for hemodialysis (HD) patients.
• Central venous stenosis (CVS) is a common but challenging complication of VA.
• The impact of CVS on flow volume (FV) and resistive index (RI) requires further investigation.

Purpose of the Study:

• To evaluate the utility of Doppler ultrasound (DUS) in assessing central venous stenosis (CVS).
• To investigate the effect of CVS on feeding artery flow volume (FV) and resistive index (RI).
• To assess the impact of percutaneous transluminal angiography (PTA) on FV and RI in patients with CVS.

Main Methods:

• Retrospective, single-center, self-controlled cohort study.
• Included patients with CVS undergoing PTA with or without stenting (January 2014 - September 2022).
• Compared FV and RI of the feeding artery before and after PTA in central venous stenosis (CVS) and mixed central and peripheral venous stenosis (MVS) groups.

Main Results:

• FV and RI were significantly affected in MVS compared to CVS.
• PTA significantly improved both FV and RI.
• Improvement rates of FV and RI were higher in MVS than in CVS.
• Establishing diagnostic or improvement cut-off values for CVS was challenging.

Conclusions:

• Doppler ultrasound (DUS) measurements of FV and RI are valuable tools for assessing central venous stenosis (CVS).
• These DUS parameters, combined with clinical findings, can aid in the evaluation of CVS in specific clinical scenarios.