Comparative Doppler flow measurements of the ulnar artery and of the postanastomotic radial artery in radiocephalic arteriovenous XXXX to detect steal syndromes.

@entity1 @entity63 @entity450 @entity292 @entity1129
OBJECTIVE: This study aims to assess whether a comparison of the Doppler flow measurements of the ulnar artery and of the postanastomotic radial artery can help detect steal syndromes at the level of native dialysis @entity292 of the wrist. @entity1 AND METHODS: We have prospectively analyzed 35 distal radiocephalic arteriovenous @entity292 presenting with postanastomotic radial artery Doppler inversion of flow. The flows of the ulnar artery and of the postanastomotic radial artery have been measured and compared. Subsequent clinical examination to detect any sign of @entity63 at the hand level was performed and the results of medical imaging were confronted with the clinical data. RESULTS: @entity1129 was discovered in a total of 6 @entity1 (17%), 4 @entity1 out of 23 displaying an ulnar flow lower than the postanastomotic radial one and 2 @entity1 among 12 with an ulnar flow higher than the radial one. Sensitivity, specificity, positive predictive value and negative predictive value of the test were 67%, 34%, 17% and 83%, respectively. Paradoxically, the mean intensity of ulnar @entity450 has been measured at 40% among true positive @entity1 and at 70% among false positive ones. We have not been able to identify any difference, be it in terms of systolic upstroke time, maximum systolic speed, telediastolic speed or in terms of global architecture of the curves between the Doppler waveforms of 4 true positive and 4 false positive @entity1 . CONCLUSION: The comparative Doppler study of the flows of the ulnar and postanastomotic radial arteries does not enable us to detect steal syndromes at the level of wrist dialysis @entity292 . Hence we consider that a systematic study of the postanastomotic radial artery flow, during routine Doppler examination of distal dialysis @entity292 , proves superfluous.
