Flow Complexity Estimation in Dysfunctional Arteriovenous Dialysis Fistulas using Vector Flow Imaging

Tin Quoc Nguyen*, Marie Sand Traberg, Jacob Bjerring Olesen, Søren Thorup Heerwagen, Andreas Hjelm Brandt, Thor Bechsgaard, Brian Lindegaard Pedersen, Ramin Moshavegh, Lars Lönn, Jørgen Arendt Jensen, Michael Bachmann Nielsen, Kristoffer Lindskov Hansen

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Non-invasive assessment is preferred for monitoring arteriovenous dialysis fistulas (AVFs). Vector concentration assesses flow complexity, which may correlate with stenosis severity. We determined whether vector concentration could assess stenosis severity in dysfunctional AVFs. Vector concentration was estimated in four stenotic phantoms at different pulse repetition frequencies. Spectral Doppler peak velocity and vector concentration were measured in 12 patients with dysfunctional AVFs. Additionally, 5 patients underwent digital subtraction angiography (DSA). In phantoms, vector concentration exhibited an inverse relationship with stenosis severity and was less affected by aliasing in severe stenoses. In nine stenoses of 5 patients undergoing DSA, vector concentration correlated strongly with stenosis severity (first stenosis: r = –0.73, p = 0.04; other stenoses; r = –0.69, p = 0.02) and mid-stenotic diameter (first stenosis: r = 0.87, p = 0.006; other stenoses: r = 0.70, p = 0.02) as opposed to peak velocities (p > 0.05). Vector concentration is less affected by aliasing in severe stenoses and correlates with DSA in patients with dysfunctional AVF.

Original languageEnglish
JournalUltrasound in Medicine and Biology
Volume46
Issue number9
Pages (from-to)2493-2504
ISSN0301-5629
DOIs
Publication statusPublished - 1 Jan 2020

Keywords

  • Arteriovenous dialysis fistula
  • Digital subtraction angiography
  • Flow complexity
  • Patient study
  • Phantom study
  • Spectral Doppler ultrasound
  • Stenosis assessment
  • Vector flow imaging

Cite this

Nguyen, T. Q., Traberg, M. S., Olesen, J. B., Heerwagen, S. T., Brandt, A. H., Bechsgaard, T., Pedersen, B. L., Moshavegh, R., Lönn, L., Jensen, J. A., Nielsen, M. B., & Hansen, K. L. (2020). Flow Complexity Estimation in Dysfunctional Arteriovenous Dialysis Fistulas using Vector Flow Imaging. Ultrasound in Medicine and Biology, 46(9), 2493-2504. https://doi.org/10.1016/j.ultrasmedbio.2020.05.021