Shear wave velocity measurements of the brachial artery in a population with end-stage renal disease

Advances in vascular anatomy and pathophysiology using high resolution and multiparametric sonography

B-mode and Color Doppler are the first-line imaging modalities in cardiovascular diseases. However, conventional ultrasound (US) provides a lower spatial and temporal resolution (70-100 frames per second) compared to ultrafast technology which acquires several thousand frames per second. Consequently, the multiparametric ultrafast platforms manage new imaging algorithms as high-frequency ultrasound, contrast-enhanced ultrasound, shear wave elastography, vector flow, and local pulse wave imaging. These advances allow better ultrasound performances, more detailed blood flow visualization and vessel walls' characterization, and many future applications for vascular viscoelastic properties evaluation.In this paper, we provide an overview of each new technique's principles and concepts and the real or potential applications of these modalities on the study of the artery and venous anatomy and pathophysiology of the upper limb before and after creating a native or prosthetic arterio-venous fistula. In particular, we focus on high-frequency ultrasound that could predict cannulation readiness and its potential role in the venous valvular status evaluation before vascular access creation; on contrast-enhanced ultrasound that could improve the peri-operative imaging evaluation during US-guided angioplasty; on shear wave elastography and local pulse wave imaging that could evaluate preoperative vessels stiffness and their potential predictive role in vascular access failure; on vector flow imaging that could better characterize the different components of the vascular access complex flow.

Increased Brachial Artery Compliance After Arteriovenous Fistula Creation as Measured by Shear Wave Elastography: Results From a Feasibility Study

OBJECTIVES

Arterial stiffness has been proposed as a marker of arteriovenous fistula failure and can be measured locally by using ultrasound shear wave elastography (SWE). This preliminary study aimed to assess whether SWE measurements of the brachial artery were associated with arteriovenous fistula failure.

METHODS

Data were collected on patients who were indicated for fistula creation. Preoperative and postoperative vessel diameters from B-mode ultrasound, brachial artery SWE maps, and demographic data were collected. Logistic and linear regression analyses were used to determine whether any of these variables were related to the outcome of the fistula 3 months after creation.

RESULTS

Data were acquired for 33 patients. Shear wave velocity values decreased after fistula creation (mean ± SD, -1.2 ± 1 m/s; P < .05). No parameters were associated with failure of the fistula in the logistic regression analysis.

CONCLUSIONS

No markers were related to fistula failure, but a decrease in the shear wave velocity was observed in the brachial arteries after fistula creation, indicating increased compliance.