Assesment of Radial Artery by Means of Doppler Ultrasonography and Soft Tissue Roentgenogram in End-Stage Renal Disease Patients


Background: Although the radial artery (RA) is mostly selected for the creating of arterio-venous fistula (AVF) in end-stage renal disease patients (ESRDP), it still represents a suitable site to simply assess systemic calcification. Our goal of this study was to research the RA before the arteriovenous fistula creation in ESRDP and evaluate the risk factor determinants. Material and Methods: The RA has been determined to estimate vascular calcification in 67 ESRDPs on dialysis by doppler ultrasonography (USG). If there was any pathologic conditions, direct examination of the forehand soft tissue roentgenograms as a simply method was made. Preoperative spectral Doppler sonography measured radial artery peak systolic velocity during tight fist clenching for 3 minutes and after fist relaxation. Vessel diameters and peak systolic velocity were assessed for predictive value based on subsequent fistula adequacy. RA calcification was scored from Grade 0 which was defined as no calcification to Grade 4 which was described as severe calcification from proximal to distal end of RA. Results: Doppler USG has shown that the major or minor RA calcification was detected in 11 patients (16.5%). In these patients, direct roentgenogram also demonstrated RA calcific disease. Total and LDL cholesterol levels, gender and smoking status have no influence on calcification scores. When the dialysis periods are concerned, there was no correlation with the RA calcification. Serum calcium and phosphate levels, rather than calcium-phosphate products, and age were correlated with high calcification scores. The highest prevalence of RA calcification was also found in diabetic group. Conclusion: Our data indicate that RA calcification is highly prevalent among ESRDP, with the highest prevalence among diabetics. The RA was used as an A-V fistual creation in ESRDPs, which may be risky since the calcification percentage is higher. Therefore, a simple roentgenographic survey may help to identify patients with severe calcified RA. Because our roengenographyc results were correlated with doppler USG, it can be used to determine RA calcific disease before the arteriovenous fistula creation.

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A. Abacilar, U. Duman and O. Dogan, "Assesment of Radial Artery by Means of Doppler Ultrasonography and Soft Tissue Roentgenogram in End-Stage Renal Disease Patients," World Journal of Cardiovascular Surgery, Vol. 4 No. 1, 2014, pp. 7-12. doi: 10.4236/wjcs.2014.41002.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] C. Acar, A. Ramsheyi, J. Pagny, V. Jebera, P. Barrier, J. Fabriani, A. Deloche, J. Guermonprez and A. Carpentier, “The Radial Artery for Coronary Artery Bypass Grafting. Clinical and Angiographic Results at Five Years,” The Journal of Thoracic and Cardiovascular Surgery, Vol. 116, No. 6, 1998, pp. 981-989.
[2] A. H. Chen, T. Nakao, R. F. Bromdan, M. Greenberg, R. Charney, M. Menegus, M. Johnson, R. Grose, R. Frame, E. C. Hu, H. Choi and S. Safyer, “Early Postoperative Angiographic Assesment of Radial Artery Grafts Used for Coronary Artery Bypass Grafting,” The Journal of Thoracic and Cardiovascular Surgery, Vol. 111, No. 6, 1996, pp. 1208-1214.
[3] F. D. da Costa, I. A. da Costa, R. Poffo, D. Abuchaim, R. Gaspar, L. Garcia and D. L. Faraco, “Myocardial Revascularisation with the Radial Artery: A Clinical and Angiographic Study,” The Annals of Thoracic Surgery, Vol. 62, No. 2, 1996, pp. 475-479.
[4] C. A. Dietl and C. H. Benoit, “Radial Artery Graft for Coronary Revascularisation: Technical Considerations,” The Annals of Thoracic Surgery, Vol. 60, 1995, pp. 102-109.
[5] P. Pola, M. Serrichio, R. Flore, E. Manasse, A. Favuzzi and G. F. Possati, “Safe Removal of the Radial Artery for Myocardial Revascularisation: A Doppler Study to Prevent Ischemic Complications to the Hand,” The Journal of Thoracic and Cardiovascular Surgery, Vol. 112, No. 3, 1996, pp. 737-744.
[6] Ruengsakulrach, M. Brooks, D. L. Hare, U. Gordon and B. F. Buxton, “Preoperative Veluation of Hand Circulation by Means of Doppler Ultrasonography and Modified-Allen Test,” The Journal of Thoracic and Cardiovascular Surgery, Vol. 121, No. 3, 2001, pp. 526-531.
[7] O. F. Dogan, M. Karcaaltincaba, U. Duman, D. Akata, A. Besim and E. Boke, “Assessment of the Radial Artery and Hand Circulation by Computed Tomography Angiography: A Pilot Study,” Heart Surgery Forum, Vol. 8, No. 1, 2005, pp. 28-33.
[8] A. Nicolasi, P. Parsons, L. L. Pohl, R. A. Cimbria and G. N. Olinger, “Increased Incidence of Radial Artery Calcification in Patients with Diabetes Mellitus,” Journal of Surgical Research, Vol. 102, No. 1, 2002, pp. 1-5.
[9] J. Nunoo-Mensah, “An Unexpected Complication after Harvesting the Radial Artery for Coronary Artery Bypass Grafting,” The Annals of Thoracic Surgery, Vol. 66, No. 3, 1998, pp. 929-931.
[10] T. Shigematsu, T. Kono, K. Satoh, K. Yokoyama, T. Yoshida and K. Shirai, “Phosphate Overload Accelerates Vascular Calcium Depositin in End Stage Renal Disease Patients,” Nephrology Dialysis Transplantation, Vol. 18, No. III, 2003, pp. 86-89.
[11] E. Kaufer, M. F. Stephen, F. Rosemary and F. B. Richard, “Pathology of the Radial Artery and Internal Thorasic Arteries Used as Coronary Artery Bypass Grafts,” The Annals of Thoracic Surgery, Vol. 63, No. 4, 1967, pp. 1118-1122.
[12] S. M. Kane-ToddHall, S. P. Taggart, H. Clements-Jewery and D. E. Roskell, “Pre-Existing Vascular Disease in the Radial Artery and Other Coronary Artery Bypass Conduits,” European Journal of Medical Research, Vol. 26, No. 41, 1999, pp. 11-14.
[13] P. Muntner, J. Coresh, M. J. Klag, et al., “History of Myocardial Infarction and Stroke among Incident and Stage Renal Disease Cases and Population Based Controls: An Analyses of Shared Risk Factors,” American Journal of Kidney Diseases, Vol. 40, No. 2, 2002, pp. 23-30.
[14] M. R. Davies and K. A. Hruska, “Pathopysiological Mechanisms of Vascular Calcificaation in end Stage Renal Disease,” Kidney International, Vol. 60, 2001, pp. 472-479.
[15] L. F. Olsson, R. Odselius, E. Ribbe and J. Hegbrant, “Evidence of Calcium Phosphate Depositions,” American Journal of Kidney Diseases, Vol. 38, No. 2, 2001, pp. 377-383.
[16] J. Gade, J. Aabech and R. I. Hansen, “The Upper Arm Arterio-Venous Fistula—An Alternative for Vascular Access in Haemodialysis,” Scandinavian Journal of Urology and Nephrology, Vol. 29, No. 2, 1995, pp. 121-124.
[17] R. Gradzki, R. K. Dhingra, F. K. Port, E. Roys, W. F. Weitzel and J. M. Messana, “Use of ACE Inhibitors Is Associated with Prolonged Survival of Arteriovenous Grafts,” American Journal of Kidney Diseases, Vol. 38, No. 6, 2001, pp. 1240-1244.

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