Arterial elasticity as a predictor for arteriovenous fistula maturation: Preliminary results

Elasticity imaging has proven useful in determining tissue abnormalities. Noninvasive ultrasound imaging and vascular measurements have the potential to increase prediction of arteriovenous (AV) fistula maturation. Chronic kidney disease (CKD) patients and normal subjects (non-CKD) were analyzed for arterial elasticity. Assuming a simple linear elastic medium, the vessel elastic modulus was calculated as the ratio of stress to tissue strain. Stress is assessed as the difference between systolic and diastolic pressure. Intima-media thickness (IMT) measurements were calculated at peak systole and diastole in the walls of the brachial artery. Strain was estimated from peak changes in IMT throughout the cardiac cycle. Preliminary results indicate elastic modulus of CKD patients were significantly higher than normal subjects (p = 0.004). Pending clinical results will confirm elastic modulus as a predictor of AV fistula maturation. It is hypothesized that noninvasive elastic modulus measurements provided by ultrasound imaging will be a successful addition to current predictors to help identify AV fistula maturation.