Effect of axillary brachial plexus block on blood flow improvement in percutaneous transluminal angioplasty for dysfunctional arteriovenous access

Abstract

Introduction:

Axillary brachial plexus block (ABPB) has been introduced for pain control during percutaneous transluminal angioplasty (PTA) of dysfunctional arteriovenous access (AVA). We investigated its impact on blood flow after PTA.

Methods:

We retrospectively analyzed PTA procedures for dysfunctional AVA between June 2024 and March 2025. Brachial artery flow volume (BAFV) was measured using ultrasonography. Relative improvement (ΔFV = (post-PTA FV − pre-PTA FV) / pre-PTA FV) was compared between ABPB and local anesthesia groups using a linear mixed-effects model adjusted for patient characteristics.

Results:

Among 1024 PTA procedures (423 patients), ABPB was used in 365 cases (35.6%). Median ΔFV was higher in ABPB than local anesthesia groups (0.90 vs 0.65; p < 0.001). ABPB was associated with greater BAFV improvement (regression coefficient, 0.46; 95% CI, 0.06–0.86; p = 0.02).

Conclusion:

ABPB was associated with greater improvement in BAFV after PTA. However, potential anesthesia selection bias remains a limitation.