All ETDs from UAB

Advisory Committee Chair

Kenneth Hoyt

Advisory Committee Members

Joel Berry

Michelle Robbin

Donald Twieg

Heidi Umphrey

Document Type

Thesis

Date of Award

2011

Degree Name by School

Master of Science in Biomedical Engineering (MSBME) School of Engineering

Abstract

This research thesis examines the applicability of using ultrasound imaging to quantify arterial elasticity and assess potential of arteriovenous fistula maturation in chronic kidney disease (CKD) patients. Tissue-specific abnormalities have proven useful for identifying disease states within oncology, cardiovascular and musculoskeletal system. Using ultrasound-based imaging to evaluate arterial elasticity is a noninvasive and novel technique. It has the potential to contribute further insight into chronic kidney disease fistula failure and become a noninvasive prognostic indicator. Reliable vascular access is critical for delivery of adequate hemodialysis treatment to CKD patients and to maintain long-term connections for dialysis. An arteriovenous fistula is a surgically generated direct anastomosis between a native artery and vein and is the preferred method available for reliable vascular access, yet up to 60% of fistula surgeries never entirely mature. Fistula maturity is based on the rate of blood flow that can be tolerated; 500 mL/min is considered successful maturation. In order to evaluate the potential of ultrasound to help determine fistula success, ultrasound mapping of the brachial artery is completed during pre-surgical evaluation of chronic kidney disease patients. In combination with echocardiogram and blood pressure measurements, an elastic modulus model allows estimation of vessel stiffness. Tracking fistula maturation and completing histological analysis of vessel samples will confirm relationships. This data will be used in conjunction with ultrasound elastic modulus measurements to correlate possible explanations for fistula failure. A comprehensive database of vascular elastic modulus measurements on normal subjects is also needed to complete this study. This will assist in determining differences in CKD patients and normal subjects. This estimation of elastic modulus using ultrasound imaging will give additional arterial biomechanical information and has potential to be a successful addition to current predictors to help identify arteriovenous fistula maturation.

Included in

Engineering Commons

Share

COinS