July 20, 2026Scientific ReportsOpen Access

Venturi-effect ultrasonography for early detection of AVF stenosis: a prospective multicenter study

Q: What are the key findings of this study?

Combining the Venturi effect with conventional ultrasonographic indicators significantly improved the diagnostic performance for early detection of arteriovenous fistula stenosis (P<0.005).

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Arteriovenous fistula (AVF) stenosis (n=169). Intervention: Venturi-effect ultrasonography combined with conventional indicators vs. Conventional ultrasonographic indicators alone. Primary outcome: Diagnostic efficacy for AVF stenosis (p=<0.005).

Q: What does this research mean for the field?

Combining assessment of the Venturi effect with conventional ultrasonographic indicators significantly improves the diagnostic performance for early detection of arteriovenous fistula stenosis. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate the diagnostic value of the Venturi effect combined with conventional ultrasonographic indicators for the early detection of arteriovenous fistula (AVF) stenosis in hemodialysis patients.

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Key result

Combining the Venturi effect with conventional ultrasound improves early detection of AVF stenosis.

P<0.005
n=169

Why the study?

The study was conducted to evaluate the diagnostic value of combining the Venturi effect with conventional ultrasonographic indicators for early detection of arteriovenous fistula stenosis in hemodialysis patients.

Does combining the Venturi effect with conventional ultrasonographic indicators improve the diagnostic efficacy for early AVF stenosis in hemodialysis patients?

Key Points

To evaluate the diagnostic value of the Venturi effect combined with conventional ultrasonographic indicators for the early detection of arteriovenous fistula (AVF) stenosis in hemodialysis patients.
Enrolled 169 patients with suspected AVF dysfunction between January 2019 and June 2024 at a nephrology department in a prospective multicenter study.
Evaluated minimal lumen diameter (MD), peak systolic velocity (PSV), peak systolic velocity ratio (PSVR), brachial artery resistance index (BA-RI), and flow volume difference (ΔFV) both individually and combined with the Venturi effect against digital subtraction angiography.
Among the 169 patients, 158 were confirmed as stenotic, with minimal lumen diameter showing the highest standalone sensitivity (93.7%) and specificity (93.8%).
Combining the Venturi effect with conventional ultrasound indicators significantly improved the diagnostic performance of PSV, PSVR, and ΔFV (P < 0.005), achieving sensitivities of 89.2% for PSV and 90.5% for PSVR.
In lesion-level analysis, 90 of 99 Venturi-positive lesions were confirmed as true anatomical stenoses (≥50% luminal reduction), yielding a positive predictive value of 90.9%.

Study Design

Type

Observational (n=169)

Blinding

Single-blind

Multicenter

Yes

Structured PICO

Does combining the Venturi effect with conventional ultrasonographic indicators improve the diagnostic efficacy for early AVF stenosis in hemodialysis patients?

Population

169 hemodialysis patients (mean age 59.1 years, 54.4% female) with suspected arteriovenous fistula insufficiency evaluated for cephalic vein stenosis.

Exposure

Venturi effect combined with conventional ultrasonographic indicators (minimal lumen diameter, peak systolic velocity, peak systolic velocity ratio, brachial artery resistance index, and flow volume difference).

Comparator

Conventional ultrasonographic indicators alone.

Outcome

Diagnostic efficacy (sensitivity, specificity, AUC) for early AVF stenosis detection compared to digital subtraction angiography (DSA).surrogate

Main Result

p-value: p=<0.005

Combining the Venturi effect with conventional ultrasound parameters significantly improves the diagnostic sensitivity and accuracy for early detection of arteriovenous fistula stenosis in hemodialysis patients.

Limitations

Treating multiple stenotic sites from the same patient as independent observations may overestimate statistical power.
All examinations were performed by one experienced physician, preventing assessment of inter-operator variability.
Unmeasured factors such as dialysis prescription details and anticoagulant medication use may have introduced confounding.
Adopting the OR rule increases sensitivity but may come at the cost of specificity.
The diagnostic performance of MD may be overestimated due to partial overlap between the enrollment criterion and the MD diagnostic threshold.
All examinations were performed by one experienced physician.

Implication

May aid noninvasive AVF stenosis detection in hemodialysis; leaves open need for validation before practice change.

Abstract

This study aims to evaluate the diagnostic value of the Venturi effect combined with conventional ultrasonographic indicators for the early detection of arteriovenous fistula (AVF) stenosis in hemodialysis patients. A total of 169 patients with suspected AVF dysfunction were enrolled from January 2019 to June 2024 at the Department of Nephrology. Ultrasound parameters assessed including the minimal lumen diameter (MD) at the suspected stenosis site of the cephalic vein, the Venturi effect presence, peak systolic velocity (PSV), peak systolic velocity ratio (PSVR), brachial artery resistance index (BA-RI), and the flow volume difference (ΔFV). The diagnostic performance of each individual conventional parameter was compared with that of its combination with the Venturi effect for early AVF stenosis detection. Among the 169 patients, 158 were confirmed as stenotic. The conventional ultrasound indicators with the highest sensitivity and specificity for diagnosing AVF stenosis were MD, with a sensitivity of 93.7% and specificity of 93.8%. The area under the receiver operating characteristic curve (AUC) of individual parameters was ranked from highest to lowest as follows: AUC_MD > AUC_BA-RI > AUC_PSV > AUC_PSVR > AUC_ΔFV. After combining the Venturi effect with each indicator, diagnostic sensitivity for AVF stenosis improved to varying degrees. Among them, the diagnostic performance of PSV, PSVR and ΔFV has significantly improved (P < 0.005). The Venturi effect combined with conventional ultrasonographic indicators demonstrates high diagnostic efficacy in the early diagnosis of AVF stenosis.

Discussion

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Cite This Study

Chen et al. (2026) conducted an observational in Arteriovenous fistula (AVF) stenosis (n=169). Venturi-effect ultrasonography combined with conventional indicators vs. Conventional ultrasonographic indicators alone was evaluated on Diagnostic efficacy for AVF stenosis (p=<0.005). Combining the Venturi effect with conventional ultrasonographic indicators significantly improved the diagnostic performance for early detection of arteriovenous fistula stenosis (P<0.005).

synapsesocial.com/papers/6a5db9da8bd453d3397ab3a0 https://doi.org/10.1038/s41598-026-62364-y

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Implication

May aid noninvasive AVF stenosis detection in hemodialysis; leaves open need for validation before practice change.

Venturi-effect ultrasonography for early detection of AVF stenosis: a prospective multicenter study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Venturi-effect ultrasonography for early detection of AVF stenosis: a prospective multicenter study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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