Abstract: Objective  To investigate brachial artery blood flow parameters assessed by color Doppler ultrasonography in the diagnosis of autologous arteriovenous fistula (AVF) complicated with cephalic vein anastomotic stenosis.  Methods  Ultrasonography was performed in 96 maintenance hemodialysis (MHD) patients with AVF. They were divided into cephalic vein anastomotic stenosis group (n=37) and non-stenosis group (n=59). Color Doppler ultrasonography was used to measure brachial artery time-averaged mean velocity (TAMV), pulsatile index (PI), resistance index (RI), peak systolic velocity (PSV), and end-diastolic velocity (EDV). These parameters were compared between the two groups. Receiver operating characteristic curve (ROC) was used to evaluate the value of brachial artery blood flow parameters in the diagnosis of AVF complicated with cephalic venous anastomotic stenosis.  Results  There were no significant differences in brachial artery diameter and RI between the two groups (P＞0.05). Brachial artery blood flow, TAMV, PSV, and EDV in the stenosis group were lower than those in the non-stenosis group, and PI in the stenosis group was higher than that in the non-stenosis group (t=12.747, 5.018, 4.377, 5.563 and 9.082 respectively; P＜0.001). ROC curve showed that brachial artery blood flow had the highest value in the diagnosis of AVF complicated with cephalic venous anastomotic stenosis, the area under curve (AUC) was 0.852 (95% CI 0.769~0.936, P＜0.001), the sensitivity was 56.76%, and the specificity was 94.59%; the AUCs of EDV, PSV, TAMV and PI were 0.764 (95% CI 0.650～0.877, P＜0.001), 0.756 (95% CI 0.640～0.872, P＜0.001), 0.701 (95% CI 0.583～0.818, P=0.003), and 0.654 (95% CI 0.518～0.790, P=0.023) respectively.   Conclusion   Monitoring of brachial artery blood flow parameters by color Doppler ultrasonography is of great value in predicting AVF complicated with cephalic venous anastomotic stenosis.

Key words: Color Doppler ultrasound, Brachial artery blood flow parameters, Autogenous arteriovenous fistula, Cephalic vein anastomotic stenosis