PMC6542321_01
Duplex scan with spectral analysis of the radial artery, proximal to the arteriovenous fistula, before surgery.
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Spectral flow analysis of the radial artery revealed a significant increase in diastolic velocity in the segment proximal of the fistula ( Figure 1 ), with reduction of diastolic velocity to normal levels beyond the fistula.
Interoperative image of arteriovenous fistula involving the radial artery and the cephalic vein in the wrist.
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In February 2018, the patient underwent surgery under local anesthesia with sedation to repair the fistula ( Figure 2 ). 
Duplex scan with spectral analysis of the radial artery, proximal of the arteriovenous fistula, after surgery.
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A duplex scan showed that diastolic velocity in the segment proximal to the fistula had normalized ( Figure 3 ) and blood gas analysis results were as follows: pH 7.426; PCO2 34; PO2 64.6; bicarbonate 22; and oxygen saturation 93.3.