The effect of chronic flow changes on brachial artery diameter and shear stress in arteriovenous fistulas for hemodialysis

Ruben Dammers*, J. H.M. Tordoir, R. J.T.H.J. Welten, P. J.E.H.M. Kitslaar, A. P.G. Hoeks

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

34 Citations (Scopus)

Abstract

Background: Vessel wall adaptation to acute or chronic flow changes is regulated by shear stress (SS) at the endothelium. This hypothesis was tested in the brachial artery (BA) of patients receiving an arteriovenous fistula (AVF) for hemodialysis vascular access. Methods: The acute and sustained effects were evaluated in 13 patients. Pre-operatively and postoperatively on predetermined time-points BA diameter and shear rate (SR) were measured. SS was calculated from whole blood viscosity and SR. Analysis was performed with Wilcoxon's test and ANCOVA multivariate analysis. Results: Acutely, mean SS increased (475%, p<0.05), peak-to-peak SS decreased (37%, p<0.05) and peak SS remained constant. BA diameter increased (15%, p<0.05). After one year a further increase was observed (r=0.59, p<0.001), plus an increase in mean SS (r=0.78, p<0.001). Peak-to-peak SS remained constant. Conclusion: Our results indicate that after AVF placement an acute increase in SS results in an acute increase of vessel diameter. However, one year of sustained high blood flow does not result in restoration of mean SS.

Original languageEnglish
Pages (from-to)124-128
Number of pages5
JournalInternational Journal of Artificial Organs
Volume25
Issue number2
DOIs
Publication statusPublished - 2002
Externally publishedYes

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