Vaidas Žvinys, Mantas Sakalauskas, Ernest Zacharevskij, Kęstutis Maslauskas, Rytis Rimdeika, Algirda Venclauskienė, Dalia Mitraitė
Ultrasound research of the blood vessels of hand and arm before the operation of the formation of the arteriovenous link is gradually becoming a necessity as it provides multiple useful information for the planning of the operation. Hospital of Lithuanian University of Health Sciences Kaunas clinics (LSMUL) is performing a prospective research based on the pre-operation ultrasound evaluation of hand and arm blood vessels. 182 patients with terminal deficiency of the renal function were researched; they were treated in LSMUL Department of Nephrology in 2008 to 2010. Before the formation of the primary arteriovenal link in the forearm, vena cephalica end to arteria radialis side (end-to-side anostomosis), the patients had hand and arm blood vessels ultrasound research performed. The age average of the patients was 64,62 ±2,31 (18-91) years, of whom males constituted 92 (50,5%). 137 patients (75,3%) underwent the operation of the left arm. Internal diameter of a. radialis and v. cephalica were being measured together with the amount of blood flowing through a. radialis as well as the state of the blood vessels (a.radialis atherosclerosis, v. cephalica thrombosis). During the operation, blood vessels were observed directly (atherosclerosis plates and calcinosis in the arteries) as well as measured. The diameter of the blood vessels when assessing in terms of gender usually was 2.01-3.00 mm regarding the arm under operation. A. radialis and v. cephalica average diameter of the crosssection area in dependence of the patient gender and the hand/ arm under operation ranged within 2.08±0.126 to 2.58±0.136 mm and 2.11±0.17 to 2,49±0,33. In different age groups, blood vessels also dominated (both a. radialis and v. cephalica) with the cross-section of 2.01 to 3.00 mm. The most frequent amount of blood flow in a. radialis was 0.01 l/min. A. radialis atherosclerosis was found in senior patients with the age average of 65.63±14.648 years. V. cephalica thrombosis was encountered in 41 patients (14 males, 27 females). The gender, age and the arm under operation do not influence the results of the operation. Patients of the senior age group who have atherosclerosis more commonly necessitate pre-operation ultrasound research in order to discover a more favourable location for the arteriovenous link.
Keyword(s): ultrasound research of the hand blood vessels; arteriovenal link; formation of the primary arteriovenal link; diameter of the hand blood vessels
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