Vascular Accesses for Haemodialysis in the Upper Arm Cause Greater Reduction in the Carotid-Brachial Stiffness than Those in the Forearm: Study of Gender Differences

Abstract

Purpose. To evaluate in chronically haemodialysed patients (CHPs), if: (1) the vascular access (VA) position (upper arm or forearm) is associated with differential changes in upper limb arterial stiffness; (2) differences in arterial stiffness exist between genders associated with the VA; (3) the vascular substitute (VS) of choice, in biomechanical terms, depends on the previous VA location and CHP gender. Methods. 38 CHPs (18 males; VA in upper arm: 18) were studied. Left and right carotid-brachial pulse wave velocity (PWVc-b) was measured. In in vitro studies, PWV was obtained in ePTFE prostheses and in several arterial and venous homografts obtained from donors. The biomechanical mismatch (BM) between CHP native vessel (NV) and VS was calculated. Results/Conclusions. PWVc-b in upper limbs with VA was lower than in the intact contralateral limbs (P < 0.05), and differences were higher (P < 0.05) when the VA was performed in the upper arm. Differences between PWVc-b in upper limbs with VA (in the upper arm) with respect to intact upper limbs were higher (P < 0.05) in males. Independently of the region in which the VA was performed, the homograft that ensured the minimal BM was the brachial artery. The BM was highly dependent on gender and the location in the upper limb in which the VA was performed.

Reference intervals and percentiles for carotid‐femoral pulse wave velocity in a healthy population aged between 9 and 87 years

“…All parameters were measured in patients after 15 minutes of rest in the supine position in a temperature‐controlled (≈22°C) room, in order to reach steady hemodynamic conditions. cfPWV was measured using two high‐fidelity strain gauges mechanotransducers (Motorola MPX 2050, Motorola Inc.) connected to an electronic signal amplifier device (Arteriometer, model V100), as described in other works . The mechanotransducers were positioned on the skin over the carotid and femoral arteries to record, simultaneously, the arterial BP waves.…”

Structural and Functional Properties of Venous Wall: Relationship between Elastin, Collagen, and Smooth Muscle Components and Viscoelastic Properties

“…Even though this is true for both veins and arteries, there is an imbalance between the existing studies and available information regarding the arterial wall and those related to the venous wall mechanics, which could be explained through several factors (e.g., methodological limitations, functional meaning of parietal mechanics, etc.). On the other hand, the biomechanical studies conducted on the venous wall correspond mainly to the field of strength of materials and are nonrealistic, static, and carried out in nonphysiological conditions [5]. Furthermore, most works do not refer to the viscous response of the wall [6].…”

Arterial Stiffness in a Rural Population of Argentina: Pilot Study

“…The validation analysis was performed as requested by the Artery Society Guidelines [20]. Data acquisition and pulse wave velocity calculation were performed using hardware and software previously reported (Arteriometer V100, Oxytech, Buenos Aires, Argentina) [21,22] to compare the data obtained with the mentioned technology against those calculated through blood flow waves (Echo-Doppler).…”

“…Briefly, we studied 21 subjects in which PWV was randomly measured on the same acquisition session through both, blood flow waves with Doppler technique [23] (Esaote My Lab 40, using a 7 MHz probe) and the Arteriometer technique (Arteriometer V100, Oxytech, Buenos Aires, Argentina) using tonometry to record the arterial pulse wave profile as previously reported [21,22]. Shortly, two high fidelity strain gauge mechano-transducers (Motorola MPX 2050, Motorola Inc., Schaumburg, Il, USA) were positioned over the carotid and femoral arteries to obtain the blood pressure waves profiles.…”

“…Measurement: Pulse wave velocity was obtained according to the technique previously published and developed in Favaloro University [21,22]. Briefly, two high-fidelity silicon piezo-resistive pressure sensors (Motorola MPX 2050, Motorola Inc., Corporate 1303 E. Algonquin Road, Schaumburg, Illinois 60196, USA) were connected to an amplifier during data acquisition.…”