Computerised analysis of auscultatory sounds associated with vascular patency of haemodialysis access |
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Authors: | Dr H A Mansy S J Hoxie N H Patel R H Sandler |
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Institution: | (1) The Biomedical Acoustics Research Group, Department of Pediatrics, Rush Medical College, Chicago, USA;(2) Department of Mechanical, Materials & Aerospace Engineering, Illinois Institute of Technology, Chicago, USA;(3) Department of Bioengineering, University of Illinois at Chicago, USA;(4) Section of Interventional Radiology, Department of Diagnostic Radiology & Nuclear Medicine, Rush University Medical Center, Chicago, USA |
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Abstract: | Vascular access for renal dialysis is a lifeline for about 120 000 individuals in the United States. Stethoscope auscultation
of vascular sounds has some utility in the assessment of access patency, yet can be highly skill-dependent. The objective
of the study was to identify acoustic parameters that are related to changes in vascular access patency. The underlying hypothesis
is that stenoses of haemodialysis access vessels or grafts cause vascular sound changes that are detectable using computerised
data acquisition and analysis. Eleven patients participated in the study. Their vascular sounds were recorded before and after
angiography, which was accompanied by angioplasty in most patients. The sounds were acquired using two electronic stethoscopes
and then digitised and analysed on a personal computer. Vessel stenosis changes were found to be associated with changes in
acoustic amplitude and/or spectral energy distribution. Certain acoustic parameters correlated well (correlation coefficient=0.98,
p<0.0001) with the change in the degree of stenosis, suggesting that stenosis severity may be predictable from these parameters.
Parameters also appeared to be sensitive to modest diameter changes (>20%), (p<0.005, Wilcoxon rank sum test). These results
suggest that computerised analysis of vascular sounds may be useful in vessel patency surveillance. Further testing using
longitudinal studies may be warranted. |
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Keywords: | Haemodialysis access stenosis or occlusion Haemodialysis graft conduit or fistula Vascular sounds Auscultation Computerised analysis Digital signal processing |
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