Ultrasound guided puncture of the brachial artery for haemodialysis fistula angiography

Background. Arterio‐venous (a–v) fistulae of haemodialysis patients frequently require function assessment by angiography. The purpose of the present study was to determine the efficacy and safety of ultrasound‐guided transbrachial catheterization when a‐v fistulae were evaluated. Methods. Between July 1996 and December 1997, 208 dialysis patients, whose a‐v fistulae (arterial inflow 150 mm Hg in three consecutive HD sessions) were at the wrist or elbow, underwent transbrachial angiography using an ultrasound‐guided 20‐gauge IA needle to evaluate fistula function. Procedure‐related symptoms or complications were noted in 28 patients and these were analysed. Results. No apparent cases of vessel spasm or thrombosis were noted. Reported symptoms in 28 patients (13.5%) included local arm pain (3.3%), transient paresthesia (0.9%), mild ecchymosis (10.6%) and haematoma (0.9%). All complications were minor and none required surgical intervention. Conclusion. Ultrasound‐guided puncture of the brachial artery is a safe, reliable and effective procedure in skilled hands and should be the preferred means of catheterization whenever haemodialysis angiography is performed.