Influence of differences in vasodilatory capacity in shunt stenosis on treatment results and inspection standards

Abstract

We investigated whether the presence/absence of vasodilation in cases of shunt stenosis affected flow volume (FV) and resistance index (RI) values, as well as outcomes and vascular access (VA) prognosis. The subjects were 96 patients who underwent ultrasound‒guided vascular access intervention therapy (VAIVT). They had stenotic cross‒sectional areas of ≤3.14 mm² in a non‒vasodilated state. They were divided into a poor vasodilation and good vasodilation groups, and the cross‒sectional area, FV, RI, and maximal diastolic pressure without avascularization before VAIVT were compared. The results suggested that the effects of treatment were weaker in the good vasodilation group than in the poor vasodilation group, in which some subjects showed significant stenosis in the non‒vasodilated state. If blood vessel cross‒sectional area in a non‒vasodilated state is used as the only criterion for VAIVT interventions, excessive therapeutic interventions may be employed. Therefore, in patients with shunt stenosis the vasodilatory capacity of the stenotic regions should be checked when considering the indications for treatment.