Usefulness of peak systolic velocity for evaluating stenotic vascular access lesions

［Background and Purpose］Ultrasound evaluations of vascular access (VA) stenosis are generally based on the diameter of the stenotic lesion (SL diameter), but in Europe and the United States evaluations based on peak systolic velocity (PSV) are performed. In this study, we investigated the usefulness of quantitative evaluations of PSV for assessing VA stenosis. ［Method］The subjects were 179 patients with arteriovenous fistulas. The SL diameter and PSV were measured on long‒axis cross sections, and the cross‒sectional area was measured on short‒axis cross sections. Receiver operating characteristic (ROC) analysis was used to compare the diagnostic ability of each item for blood removal failure. We also performed a PSV correlation analysis. ［Results］In the ROC analysis, the SL diameter and cross‒sectional area exhibited high diagnostic ability for poor blood removal, and there was no difference between the two, but the diagnostic ability of PSV was significantly low. Furthermore, PSV displayed weak correlations with cross‒sectional area and SL diameter. ［Conclusion］PSV was not found to be useful in a quantitative evaluation of VA stenosis based on ultrasound.