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ORIGINAL ARTICLE   

Chirurgia 2021 February;34(1):21-4

DOI: 10.23736/S0394-9508.20.05092-5

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Determination of early adaptive flow and diameter changes following creation of radiocephalic arteriovenous fistula for hemodialysis

Selim DURMAZ

Deparment of Cardiovascular Surgery, Aydin Adnan Menderes University, Aydin, Turkey



BACKGROUND: There are several factors affecting the maturation of radiocephalic arteriovenous fistula (AVF) created for hemodialysis including the vessel size and preoperative flow status. The aim of this study was to investigate the preoperative and postoperative determinative effects of arterial flow and vessel lumen diameters on AVF maturation.
METHODS: A total of one hundred patients requiring AVF for chronic renal replacement therapy were included in the study. The diameter, flow velocity and flow rate of radial artery and the diameter of cephalic vein were measured by doppler ultrasonography preoperatively and at postoperative first month. The Kendall’s Tau test was used for correlation of the diameter of cephalic vein and the postoperative flow rate of AV fistula. Paired sample t-test was used to compare the preoperative and postoperative measured values.
RESULTS: The diameter of cephalic vein measured preoperatively was found to correlate significantly with the AVF flow rates. However, the radial artery diameter was not found to significantly effect AVF flow. AVF flow velocity with a preoperative cephalic vein diameter greater than 1.75 mm was found to be higher than 500 mL/min at the first month after the operation.
CONCLUSIONS: The results of the present study showed that maturation of radiocephalic AVF correlates well with the diameter of cephalic vein but not with the diameter of radial artery measured in the preoperative period. Although the suggested cut off point of the cephalic vein for the adequate maturation of radiocephalic AVF is 2 mm it was observed that sufficient flow for hemodialysis access can be obtained for lower vein diameters.


KEY WORDS: Arteriovenous fistula; Renal insufficiency; Renal dialysis

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