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        "resumen" => "Introduction&#46; The CDU is a noninvasive vascular access &#40;VA&#41; monitoring technique that provides both structural and hemodynamic information from vessels&#46; Objective&#46; The aim of this prospective study was to analyze some parameters of forearm vessels by CDU before and after RCF creation at the wrist&#46; Patients and methods&#46; We explored by CDU the vessels of forearm in 34 CRF patients &#40;pts&#41; &#40;mean age 63&#46;9¿15&#46;1 yr&#44; sex M&#58;76&#46;5&#37;&#59;F&#58;23&#46;5&#37;&#44; 26&#46;5&#37; diabetes&#44; 73&#46;5&#37; already on HD at the time of RCF placement&#41;&#46; Forearm CDU evaluation was planned twice&#58; before RCF creation &#40;first exploration FE&#41; and after two months of successful RCF cannulation for HD by 2 needles at Qb&#62;250 ml&#47;min &#40;second exploration SE&#41;&#46; All CDU examinations were performed by the same radiologist with 5-10 MHz linear transducer &#40;Doppler angle ¿ 60&#186;&#41; at two proximal and distal points of the forearm &#40;the values were averaged&#41; using the Aspen machine &#40;Siemens-Acuson&#44; Mountain View&#44; CA&#41;&#46; We measured by CDU parameters from radial artery RA &#40;diameter RAd&#44; peak systolic velocity PSV&#44; resistive index RI&#44; blood flow rate RAflow&#41;&#44; cephalic vein CV &#40;diameter CVd&#41; and arterialized vein AV &#40;diameter AVd&#44; blood flow rate AVflow&#41;&#46; RAflow or AVflow calculation by CDU&#58; time average velocity &#40;mean of three cardiac cycles&#41; &#40;m&#47;s&#41; x cross-sectional area &#40;mm2&#41; x 60&#46; RCF outcome&#58; functioning RCF &#40;FRCF&#41; suitable for routine HD 61&#46;8&#37; &#40;mean age 61&#46;2¿14&#46;5 yr&#44; 23&#46;8&#37; diabetes&#41;&#44; or non-functioning RCF 38&#46;2&#37; &#40;mean age 68&#46;2¿15&#46;5 yr&#44; 30&#46;8&#37; diabetes&#41; due to&#58; early thrombosis &#40;within 24 hours after operation&#44; ETRCF&#41; 14&#46;7&#37;&#44; lack of RCF maturation &#40;LMRCF&#41; 5&#46;9&#37;&#44; last thrombosis &#40;between 24 hours after operation and SE by CDU&#44; LTRCF&#41; 17&#46;6&#37;&#46; Results&#46; Between FE and SE by CDU at RA&#44; overall mean RAd &#40;3&#46;2¿0&#46;3 vs 5&#46;5¿1&#46;0 mm&#41;&#44; mean PSV &#40;59&#46;9¿12&#46;4 vs 166&#46;6¿58&#46;2 cm&#47;s&#41; and mean RAflow &#40;67&#46;9¿27&#46;4 vs 1297&#46;1¿683&#46;1 ml&#47;min&#41; increased significantly &#40;for all comparisons&#44; p <0 001 and mean ri 0 9 61617 2 vs 4 1 decreased significantly p <0 001 we also found a significant difference when overall mean cvd 2 9 61617 0 6 mm and avd 5 7 1 were compared p <0 001 overall and distal mean raflow at fe by cdu were lower in pts with etrcf 33 6 61617 19 26 0 16 7 ml min respectively compared to frcf 67 9 27 4 48 21 3 p="0&#46;049&#41;&#46;" lmrcf considered together 20 had rad 2 8 mm 28 1 15 no significant differences between ltrcf found when psv ri cvd obtained for all comparisons but underwent hd the time of rcf creation 57 who avflow 8804 800 38 avflow: 602 5 167 showed se 800 ml&#47;min &#40;61&#46;9&#37;&#44; mean AVflow&#58; 1113&#46;9¿160&#46;1 ml&#47;min&#41;&#58; 820&#46;1¿188&#46;7 vs 1590&#46;7¿715&#46;4 ml&#47;min &#40;p&#61;0&#46;002&#41;&#46; We found a positive correlation between overall mean AVflow and mean RAflow obtained at SE by CDU &#40;r &#61; 0&#46;52&#44; p &#61; 0&#46;016&#41;&#46; Conclusions&#46; 1&#41; All parameters of forearm vessels measured by CDU changed after RCF placement&#46; 2&#41; Preoperative mean RAflow is predictive of RCF outcome&#46; 3&#41; Mean AVflow is related to mean RAflow obtained at SE by CDU&#46; </0> </0> </0>"
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        "resumen" => "Introducci&#243;n&#46; La EDC permite efectuar un estudio anat&#243;mico y funcional del &#225;rbol vascular&#46; Objetivos&#46; Analizar diferentes par&#225;metros de los vasos sangu&#237;neos del antebrazo por EDC antes y despu&#233;s de la construcci&#243;n de la FRC en el carpo&#46; Material y m&#233;todos&#46; Hemos explorado prospectivamente el antebrazo de 34 pacientes &#40;pts&#41; con IRC &#40;edad 63&#46;9¿15&#46;1 a&#241;os&#44; sexo H&#58;76&#46;5&#37;&#59;M&#58;23&#46;5&#37;&#44; 26&#46;5&#37; diabetes&#44; 73&#46;5&#37; ya efectuaban HD en el momento de efectuar la FRC&#41; mediante EDC&#46; La evaluaci&#243;n por EDC se planific&#243; por duplicado&#58; antes de la creaci&#243;n de la FRC &#40;primera exploraci&#243;n PE&#41; y dos meses despu&#233;s de la punci&#243;n sin problemas de la FRC con 2 agujas y Qb&#62;250 ml&#47;min &#40;segunda exploraci&#243;n SE&#41;&#46; Todas las exploraciones se efectuaron por el mismo radi&#243;logo mediante un transductor lineal de 5-10 MHz &#40;monitor de EDC Aspen&#44; Siemens-Acuson&#44; Mountain View&#44; CA&#41; aplicado sobre 2 puntos diferentes &#40;proximal y distal&#41; del antebrazo &#40;ambos valores se promediaron&#41;&#46; Se determinaron por EDC par&#225;metros de la arteria radial AR &#40;di&#225;metro dAR&#44; velocidad m&#225;xima sist&#243;lica VMS&#44; &#237;ndice de resistencia IR&#44; flujo sangu&#237;neo flujoAR&#41;&#44; vena cef&#225;lica VC &#40;di&#225;metro dVC&#41; y vena arterializada VA &#40;di&#225;metro dVA&#44; flujo sangu&#237;neo flujoVA&#41;&#46; C&#225;lculo de flujoAR &#243; flujoVA por EDC &#40;ml&#47;min&#41;&#58; curva tiempo-velocidad &#40;media de 3 ciclos card&#237;acos&#41; &#40;m&#47;s&#41; x &#225;rea transversal &#40;mm2&#41; x 60&#46; Seguimiento de la FRC&#58; FRC funcionante &#40;FRCF&#41; 61&#46;8&#37;&#44; &#243; FRC no funcionante 38&#46;2&#37; por&#58; trombosis inicial &#40;durante las 24 horas siguientes a la intervenci&#243;n&#44; TIFRC&#41; 14&#46;7&#37;&#44; falta de maduraci&#243;n &#40;FMFRC&#41; 5&#46;9&#37;&#44; trombosis tard&#237;a &#40;entre las 24 horas post-intervenci&#243;n y la SE por EDC&#44; TTFRC&#41; 17&#46;6&#37;&#46; Resultados&#58; Entre PE y SE por EDC sobre la AR&#44; los valores globales de dAR &#40;3&#46;2¿0&#46;3 vs 5&#46;5¿1&#46;0 mm&#41;&#44; VMS &#40;59&#46;9¿12&#46;4 vs 166&#46;6¿58&#46;2 cm&#47;s&#41; y flujoAR &#40;67&#46;9¿27&#46;4 vs 1297&#46;1¿683&#46;1 ml&#47;min&#41; aumentaron &#40;para todas las comparaciones&#44; p <0 001 y el ir 0 9 61617 2 vs 4 1 disminuyó p <0 001 también diferencia significativa al comparar dvc 2 9 61617 0 6 mm y dva 5 7 1 globales p <0 001 el flujoar medio global y distal obtenido en la pe por edc fue menor los pts con tifrc 33 6 61617 19 26 0 16 7 ml min respectivamente relación a frcf 67 9 27 4 48 21 3 p="0&#46;049&#41;&#46;" fmfrc considerados conjuntamente 20 presentaron dar 2 8 mm 28 1 15 sin diferencias entre ttfrc al comparar vms ir dvc obtenidos para todas las comparaciones pero todos ya estaban programa de hd cuando se construyó frc 57 flujova 8804 800 38 flujova: 602 5 167 un 800 ml&#47;min &#40;61&#46;9&#37;&#44; flujoVA&#58; 1113&#46;9¿160&#46;1 ml&#47;min&#41;&#58; 820&#46;1¿188&#46;7 vs 1590&#46;7¿715&#46;4 ml&#47;min &#40;p&#61;0&#46;002&#41;&#46; Hemos objetivado una correlaci&#243;n positiva entre flujoVA y flujoAR medio global obtenidos en la SE por EDC &#40;r &#61; 0&#46;52&#44; p &#61; 0&#46;016&#41;&#46; Conclusiones&#58; 1&#41; Todos los par&#225;metros vasculares del antebrazo determinados por EDC cambian tras la construcci&#243;n de la FRC&#46; 2&#41; El flujoAR obtenido antes de la intervenci&#243;n es predictivo de funcionamiento de la FRC&#46; 3&#41; El flujoVA est&#225; en relaci&#243;n con el flujoAR obtenido en la SE por EDC&#46; </0> </0> </0>"
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Vol. 27. Issue. 4.August 2007
Pages 399-525
Vol. 27. Issue. 4.August 2007
Pages 399-525
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Noninvasive assessment of forearm vessels by color doppler ultrasonography (CDU) before and after radiocephalic fistula (RCF) placement
Exploración vascular no invasiva del antebrazo mediante ecografía doppler color (EDC) antes y después de la construcción de la fístula radiocefálica (FRC)
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Ramon Roca-Tey, Amelia Rivas*, Rosa Samon, Omar Ibrik, Román Martínez-Cercós**, Jordi Viladoms
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Introduction. The CDU is a noninvasive vascular access (VA) monitoring technique that provides both structural and hemodynamic information from vessels. Objective. The aim of this prospective study was to analyze some parameters of forearm vessels by CDU before and after RCF creation at the wrist. Patients and methods. We explored by CDU the vessels of forearm in 34 CRF patients (pts) (mean age 63.9¿15.1 yr, sex M:76.5%;F:23.5%, 26.5% diabetes, 73.5% already on HD at the time of RCF placement). Forearm CDU evaluation was planned twice: before RCF creation (first exploration FE) and after two months of successful RCF cannulation for HD by 2 needles at Qb>250 ml/min (second exploration SE). All CDU examinations were performed by the same radiologist with 5-10 MHz linear transducer (Doppler angle ¿ 60º) at two proximal and distal points of the forearm (the values were averaged) using the Aspen machine (Siemens-Acuson, Mountain View, CA). We measured by CDU parameters from radial artery RA (diameter RAd, peak systolic velocity PSV, resistive index RI, blood flow rate RAflow), cephalic vein CV (diameter CVd) and arterialized vein AV (diameter AVd, blood flow rate AVflow). RAflow or AVflow calculation by CDU: time average velocity (mean of three cardiac cycles) (m/s) x cross-sectional area (mm2) x 60. RCF outcome: functioning RCF (FRCF) suitable for routine HD 61.8% (mean age 61.2¿14.5 yr, 23.8% diabetes), or non-functioning RCF 38.2% (mean age 68.2¿15.5 yr, 30.8% diabetes) due to: early thrombosis (within 24 hours after operation, ETRCF) 14.7%, lack of RCF maturation (LMRCF) 5.9%, last thrombosis (between 24 hours after operation and SE by CDU, LTRCF) 17.6%. Results. Between FE and SE by CDU at RA, overall mean RAd (3.2¿0.3 vs 5.5¿1.0 mm), mean PSV (59.9¿12.4 vs 166.6¿58.2 cm/s) and mean RAflow (67.9¿27.4 vs 1297.1¿683.1 ml/min) increased significantly (for all comparisons, p <0 001 and mean ri 0 9 61617 2 vs 4 1 decreased significantly p <0 001 we also found a significant difference when overall mean cvd 2 9 61617 0 6 mm and avd 5 7 1 were compared p <0 001 overall and distal mean raflow at fe by cdu were lower in pts with etrcf 33 6 61617 19 26 0 16 7 ml min respectively compared to frcf 67 9 27 4 48 21 3 p="0.049)." lmrcf considered together 20 had rad 2 8 mm 28 1 15 no significant differences between ltrcf found when psv ri cvd obtained for all comparisons but underwent hd the time of rcf creation 57 who avflow 8804 800 38 avflow: 602 5 167 showed se 800 ml/min (61.9%, mean AVflow: 1113.9¿160.1 ml/min): 820.1¿188.7 vs 1590.7¿715.4 ml/min (p=0.002). We found a positive correlation between overall mean AVflow and mean RAflow obtained at SE by CDU (r = 0.52, p = 0.016). Conclusions. 1) All parameters of forearm vessels measured by CDU changed after RCF placement. 2) Preoperative mean RAflow is predictive of RCF outcome. 3) Mean AVflow is related to mean RAflow obtained at SE by CDU.
Keywords:
Color Doppler ultrasonography
Radiocephalic fistula
Radial artery flow
Arterialized vein flow
Introducción. La EDC permite efectuar un estudio anatómico y funcional del árbol vascular. Objetivos. Analizar diferentes parámetros de los vasos sanguíneos del antebrazo por EDC antes y después de la construcción de la FRC en el carpo. Material y métodos. Hemos explorado prospectivamente el antebrazo de 34 pacientes (pts) con IRC (edad 63.9¿15.1 años, sexo H:76.5%;M:23.5%, 26.5% diabetes, 73.5% ya efectuaban HD en el momento de efectuar la FRC) mediante EDC. La evaluación por EDC se planificó por duplicado: antes de la creación de la FRC (primera exploración PE) y dos meses después de la punción sin problemas de la FRC con 2 agujas y Qb>250 ml/min (segunda exploración SE). Todas las exploraciones se efectuaron por el mismo radiólogo mediante un transductor lineal de 5-10 MHz (monitor de EDC Aspen, Siemens-Acuson, Mountain View, CA) aplicado sobre 2 puntos diferentes (proximal y distal) del antebrazo (ambos valores se promediaron). Se determinaron por EDC parámetros de la arteria radial AR (diámetro dAR, velocidad máxima sistólica VMS, índice de resistencia IR, flujo sanguíneo flujoAR), vena cefálica VC (diámetro dVC) y vena arterializada VA (diámetro dVA, flujo sanguíneo flujoVA). Cálculo de flujoAR ó flujoVA por EDC (ml/min): curva tiempo-velocidad (media de 3 ciclos cardíacos) (m/s) x área transversal (mm2) x 60. Seguimiento de la FRC: FRC funcionante (FRCF) 61.8%, ó FRC no funcionante 38.2% por: trombosis inicial (durante las 24 horas siguientes a la intervención, TIFRC) 14.7%, falta de maduración (FMFRC) 5.9%, trombosis tardía (entre las 24 horas post-intervención y la SE por EDC, TTFRC) 17.6%. Resultados: Entre PE y SE por EDC sobre la AR, los valores globales de dAR (3.2¿0.3 vs 5.5¿1.0 mm), VMS (59.9¿12.4 vs 166.6¿58.2 cm/s) y flujoAR (67.9¿27.4 vs 1297.1¿683.1 ml/min) aumentaron (para todas las comparaciones, p <0 001 y el ir 0 9 61617 2 vs 4 1 disminuyó p <0 001 también diferencia significativa al comparar dvc 2 9 61617 0 6 mm y dva 5 7 1 globales p <0 001 el flujoar medio global y distal obtenido en la pe por edc fue menor los pts con tifrc 33 6 61617 19 26 0 16 7 ml min respectivamente relación a frcf 67 9 27 4 48 21 3 p="0.049)." fmfrc considerados conjuntamente 20 presentaron dar 2 8 mm 28 1 15 sin diferencias entre ttfrc al comparar vms ir dvc obtenidos para todas las comparaciones pero todos ya estaban programa de hd cuando se construyó frc 57 flujova 8804 800 38 flujova: 602 5 167 un 800 ml/min (61.9%, flujoVA: 1113.9¿160.1 ml/min): 820.1¿188.7 vs 1590.7¿715.4 ml/min (p=0.002). Hemos objetivado una correlación positiva entre flujoVA y flujoAR medio global obtenidos en la SE por EDC (r = 0.52, p = 0.016). Conclusiones: 1) Todos los parámetros vasculares del antebrazo determinados por EDC cambian tras la construcción de la FRC. 2) El flujoAR obtenido antes de la intervención es predictivo de funcionamiento de la FRC. 3) El flujoVA está en relación con el flujoAR obtenido en la SE por EDC.
Palabras clave:
Ecografia Doppler color
Fístula radiocefálica
Flujo de la arteria radial
Flujo de la vena arterializada
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Nefrología (English Edition)
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