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©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
Combined functional and anatomical diagnostic endpoints for assessing arteriovenous fistula dysfunction
Ehsan Rajabi-Jaghargh, Rupak K Banerjee, Mechanical Engineering Program, Department of Mechanical and Materials Engineering, University of Cincinnati, Cincinnati, OH 45221-0072, United States
Rupak K Banerjee, Biomedical Engineering Program, Department of Biomedical, Chemical, University of Cincinnati, Cincinnati, OH 45221-0072, United States
Rupak K Banerjee, Environmental Engineering, University of Cincinnati, Cincinnati, OH 45221-0072, United States
Rupak K Banerjee, Cincinnati Veterans Administration Medical Center, Cincinnati, OH 45221-0072, United States
Author contributions: All authors contributed to this work.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Rupak K Banerjee, PE, PhD, Mechanical Engineering Program, Department of Mechanical and Materials Engineering, University of Cincinnati, 593 Rhodes Hall, Cincinnati, OH 45221-0072, United States. rupak.banerjee@uc.edu
Telephone: +1-513-5562124 Fax: +1-513-5563390
Received: July 19, 2014
Peer-review started: July 19, 2014
First decision: August 14, 2014
Revised: November 7, 2014
Accepted: November 17, 2014
Article in press: November 19, 2014
Published online: February 6, 2015
Processing time: 203 Days and 2.4 Hours
Peer-review started: July 19, 2014
First decision: August 14, 2014
Revised: November 7, 2014
Accepted: November 17, 2014
Article in press: November 19, 2014
Published online: February 6, 2015
Processing time: 203 Days and 2.4 Hours
Core Tip
Core tip: Current surveillance strategies are based on either flow (Qa) or pressure (VAPR) measurements. The Qa has only shown to be a good predictor of inflow stenosis in arteriovenous fistulas (AVFs). The VAPR was primarily developed to detect outflow stenosis in arteriovenous grafts and has shown to be a poor predictor of stenosis in AVFs. These limitations have been associated with the fact that both pressure and flow change in the presence of a stenosis and thus, hemodynamic diagnostic endpoints that employ only one of these parameters are inherently prone to inaccuracies. Thus, diagnostic endpoints that can combine both effects of pressure and flow can provide better assessment of stenosis severity in AVFs.