Improvement in the visualization of superficial arm veins being evaluated for access and bypass

Bemmelen, Paul S. van; Kelly, Patrick J.; Blebea, John

doi:10.1016/j.jvs.2005.06.021

Cited by 44 publications

(52 citation statements)

References 10 publications

(8 reference statements)

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“…The NKF-KDOQI guideline suggested that the preferable mean venous diameter should be ≥2.5 mm and arterial diameter ≥1.6 mm for successful AVF creation [8]. Different from artery, vein size may vary tremendously in response to body posture, stress, and external environment [5, 6]. One would therefore prefer that ultrasound vein size assessment captures the maximum potential of the vein to facilitate clinical decision and, hence, better outcome [9].…”

Section: Discussionmentioning

confidence: 99%

“…Thus many researchers conducted studies to find out the optimal protocol for superficial vein size assessment. Van Bemmelen et al and Korten et al had examined the effect of body posture, tourniquet, and regional warm reagent around the upper limb on size of superficial vein [5, 6]. Their results state that warm water immersion of the limb and increased hydrostatic pressure during sitting increase venous diameter.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous studies had explored thoroughly the potential of body positioning on vein size [5, 6]. However, not much work had investigated the effect of external environment.…”

Section: Introductionmentioning

confidence: 99%

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Revealing Maximal Diameter of Upper Limb Superficial Vein with an Elevated Environmental Temperature

Irfan

Ooi

Kyin

et al. 2016

International Journal of Chronic Diseases

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Ultrasonography is the primary tool for preoperative analysis of vein morphology for fistula creation in patients with end-stage renal disease. This study examines the effect of environmental temperature on the superficial vein size. Superficial veins of thirteen healthy volunteers were marked at three sites: cephalic vein in left lateral arm near cubital fossa, cephalic vein in left forearm at wrist, and basilic vein in left medial arm near cubital fossa. Mean diameters were recorded using ultrasound probe at 26°C and 43°C. Body temperature was increased using a Bair Hugger blanket. Mean values from the two temperatures were analyzed using paired sample t-test. All three superficial vein sites displayed statistically significant increase in diameter when the temperature was increased from 26°C to 43°C. Paired t-test showed p values of 0.001 for cephalic vein at wrist, 0.01 for cephalic vein near cubital fossa, and 0.01 for basilic vein near cubital fossa. This study proved that environmental temperature exerts a statistically significant effect on vein size measured by ultrasound during preoperative assessment for vascular access. Not to the extent of 43°C, the authors would recommend setting the room temperature higher during ultrasound vascular assessment to avoid underestimating the superficial vein size.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Revealing Maximal Diameter of Upper Limb Superficial Vein with an Elevated Environmental Temperature

Irfan

Ooi

Kyin

et al. 2016

International Journal of Chronic Diseases

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show abstract

“…Central venous pressure, positioning of the arm, hydration status, ambient room temperature, caffeine, and medications may contribute to misleading scans. 7 The present study by Kakkos et al used routine tourniquet derived cephalic vein measurements, the benefit of which remains unproven. 4 Though widely recommended, even duplex mapping did not improve functional AVF patency in a recent systematic review.…”

mentioning

confidence: 93%

Is There an Accurate Pre-operative Criterion for Dialysis Access Artery or Vein diameter?

Cook

Padberg

2017

European Journal of Vascular and Endovascular Surgery

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“…While several studies have investigated maneuvers to increase femoral and jugular vein size to facilitate ultrasound-guided central line placement [10-14], few have evaluated maneuvers to increase basilic vein size. Studies evaluating basilic vein size have mainly focused on the creation of an AV fistula for dialysis rather than facilitating USGPIV [15-20]. The objective of this study is to evaluate maneuvers practical for ED use that could be utilized to improve the success of USGPIV by increasing basilic vein size.…”

Section: Introductionmentioning

confidence: 99%

Can we make the basilic vein larger? maneuvers to facilitate ultrasound guided peripheral intravenous access: a prospective cross-sectional study

et al. 2011

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BackgroundStudies have shown that vein size is an important predictor of successful ultrasound-guided vascular access. The objective of this study is to evaluate maneuvers designed to increase basilic vein size, which could be used to facilitate ultrasound-guided peripheral intravenous access (USGPIV) in the Emergency Department (ED) setting.MethodsThis was a prospective non-randomized trial. Healthy volunteers aged 18-65 were enrolled. Basilic veins were identified and the cross-sectional area measured sonographically. Following baseline measurement, the following maneuvers were performed: application of a tourniquet, inflation of a blood pressure (BP) cuff, application of a tourniquet with the arm lowered, and BP cuff inflation with the arm lowered. Following each maneuver there was 30 s of recovery time, and a baseline measurement was repeated to ensure that the vein had returned to baseline. Change in basilic vein size was modeled using mixed model analysis with a Tukey correction for multiple comparisons to determine if significant differences existed between different maneuvers.ResultsOver the 5-month study period, 96 basilic veins were assessed from 52 volunteers. All of the maneuvers resulted in a statistically significant increase in basilic vein size from baseline (p < 0.001). BP cuff inflation had the greatest increase in vein size from baseline 17%, 0.87 mm 95% CI (0.70-1.04). BP cuff inflation statistically significantly increased vein size compared to tourniquet placement by 3%, 0.16 mm 95% CI (0.02-0.30).ConclusionsThe largest increase in basilic vein size was due to blood pressure cuff inflation. BP cuff inflation resulted in a statistically significant increase in vein size compared to tourniquet application, but this difference may not be clinically significant.

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Improvement in the visualization of superficial arm veins being evaluated for access and bypass

Cited by 44 publications

References 10 publications

Revealing Maximal Diameter of Upper Limb Superficial Vein with an Elevated Environmental Temperature

Revealing Maximal Diameter of Upper Limb Superficial Vein with an Elevated Environmental Temperature

Is There an Accurate Pre-operative Criterion for Dialysis Access Artery or Vein diameter?

Can we make the basilic vein larger? maneuvers to facilitate ultrasound guided peripheral intravenous access: a prospective cross-sectional study

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