Nicoladoni–Branham sign

The Nicoladoni–Branham sign (also called Branham's sign, the Nicoladoni sign, or the Nicoladoni–Israel–Branham sign) is named after Carl Nicoladoni, who first noticed the phenomenon of the pulse slowing in a patient with right arm phlebarteriectasia when the brachialis artery proximal to it was compressed. In modern medicine, the sign is elicited when pressure is applied to an artery proximal to an arteriovenous fistula and said to be positive if the following occurs:

  • Swelling reduces in size
  • Bruit and thrill disappears
  • Blood pressure rises
  • Pulse rate and heart rate return to normal.
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