Ultrasound guided puncture of the brachial artery for haemodialysis fistula angiography

Background. Arterio-venous (a-v) fistulae of haemodialysis patients frequen tly require function assessment by angiography. The purpose of the present study was to determine the efficacy and safety of ultrasound-guided transbr achial catheterization when a-v fistulae were evaluated. Methods. Between July 1996 and December 1997, 208 dialysis patients, whose a-v fistulae (arterial inflow < 50 ml/min or venous pressure > 150 mm Hg in three consecutive HD sessions) were at the wrist or elbow, underwent trans brachial angiography using an ultrasound-guided 20-gauge IA needle to evalu ate fistula function. Procedure-related symptoms or complications were note d in 28 patients and these were analysed. Results. No apparent cases of vessel spasm or thrombosis were noted. Report ed symptoms in 28 patients (13.5%) included local arm pain (3.3%), transien t paresthesia (0.9%), mild ecchymosis (10.6%) and haematoma (0.9%). All com plications were minor and none required surgical intervention. Conclusion. Ultrasound-guided puncture of the brachial artery is a safe, re liable and effective procedure in skilled hands and should be the preferred means of catheterization whenever haemodialysis angiography is performed.