Relationship between shunt sounds at anastomotic sites and mean brachial artery blood flow and vascular resistance index according to Doppler ultrasound

Abstract

We reported that the quality of shunt sounds can be quantified and evaluated by artificial intelligence. However, information on the auscultatory sites was missing, and few predictors of obstruction were identified. In addition, it is difficult to predict occlusion based on the mean brachial artery blood flow and vascular resistance index according to Doppler ultrasound because the blood flow through a shunt with many branches is unlikely to decrease if one branch becomes occluded. We consider that shunt sounds from the anastomotic site alone, which are easy to record, may be related to the above ultrasonic findings. Comparisons were made of the sound quality at the shunt anastomosis, the mean brachial artery blood flow according to ultrasound, and the vascular resistance index. As a result, the mean brachial artery blood flow, which indicates shunt blood flow, was found to be correlated with the intensity of shunt auscultatory sounds. The vascular resistance index as indicated by ultrasonic waves was weakly correlated with intermittent sounds assessed by artificial intelligence. It is considered possible to indirectly evaluate shunt blood flow through daily auscultation. However, performing auscultation over the entire length of the shunt, not just at the anastomotic site, is important for assessing stenotic sounds.