Prophylactic use of intravenous prostaglandin E 1 for radial arterial spasm in uremic patients undergoing construction of arteriovenous hemodialysis fistulas

Abstract

Radial arterial spasm in uremic patients undergoing construction of internal arteriovenous (AV) dialysis fistulas was investigated transcutaneously using ultrasonic Doppler flowmetry. In 6 of 16 control patients, the radial arterial blood flow was significantly decreased for 20 min after anastomosing, indicating vasospasm. Vasospasm did not occur in 15 patients who were continuously administered prostaglandin E₁ (PGE₁) intravenously (10 ng/kg/min) during surgery. The arterial blood flow was significantly increased in patients receiving PGE₁ in comparison with control patients not receiving PGE₁ and in whom vasospasm did not occur. Regarding patency of hemodialysis access, the fistula was obstructed in one control patient with radial arterial spasm, but not in patients with PGE₁ infusion. Our study suggests that PGE₁ may be effective in preventing vasospasm in patients undergoing placement of internal AV dialysis fistulas.