Post‐operative arterio‐venous fistula blood flow influences primary and secondary patency following access surgery

Benaragama, Kapila S.; Barwell, Jennifer; Lord, Christopher J.; John, Biku Joseph; Babber, Adarsh; Sandoval, Shella; Lindsey, Ben; Fernando, Bimbi

doi:10.1111/jorc.12238

Cited by 10 publications

(6 citation statements)

References 30 publications

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“…If DUS indicates anastomotic stenosis, low anastomotic PSV, small forearm vessels diameter, small brachial artery diameter, low brachial artery PSV, or FV, additional intervention such as BAM is considered to improve the functional maturation and long-term patency rates. The results are partially identical to the previous study ( 26 ).…”

Section: Discussionsupporting

confidence: 90%

The feasibility of small-caliber veins for autogenous arteriovenous fistula creation: A single-center retrospective study

Feng

Wang

Chang

et al. 2023

Front. Cardiovasc. Med.

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ObjectiveAutogenous arteriovenous fistula (AVF) is recommended as the first choice for hemodialysis vascular access. A small-caliber vein is one of the independent risk factors for AVF maturation and patency. However, the specific threshold is still unclear, making it difficult to accurately determine whether these vessels are suitable for AVF creation.DesignThis is a single-center retrospective study.MethodPatients who underwent AVF creation in our medical center between January 2020 and September 2022 and satisfied the eligibility criteria were included in this retrospective study. Logistic regression analysis was performed to identify risk factors for functional maturation and additional intervention. The optimal cutoff value was determined based on the receiver operating curve (ROC) and the Youden index. Kaplan–Meier analysis was utilized in further patency rate comparisons.ResultA total of 125 forearm AVFs were created in 121 patients with end-stage renal disease (ESRD). The mean age was 53.88 ± 15.10 years. Preoperative vascular Doppler ultrasound (DUS) was conducted and recorded in 106 cases (84.80%). The mean targeted artery and vein diameters were 2.17 ± 0.54 and 1.71 ± 0.75 mm, respectively. Small-caliber vein is the risk factor for functional maturation failure (OR = 0.256, 95%CI [0.06–0.75], p = 0.033) and additional intervention (OR = 0.306, 95% CI [0.09–0.78], p = 0.031). The optimal cutoff value is 1.35 mm (augmented) when specificity and sensitivity reach 80 and 63.7%, respectively. The AVFs with a vein diameter of more than 1.35 mm (augmented) showed higher patency rates (p < 0.01).ConclusionAfter comprehensive DUS evaluation, intraoperative hydrodilation, postoperative active exercise and intensive DUS detection, and application of balloon-assisted maturation, if necessary, using a vein more than 1.35 mm (augmented), could achieve satisfactory functional maturation and postoperative patency in AVF formation.

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Section: Discussionsupporting

confidence: 90%

The feasibility of small-caliber veins for autogenous arteriovenous fistula creation: A single-center retrospective study

Feng

Wang

Chang

et al. 2023

Front. Cardiovasc. Med.

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“…Other observational studies have reiterated this same relationship between postoperative BF and AVF failure, identifying cutoff points ranging from 160 mL/min to 300 mL/min. 15 , 16…”

Section: Discussionmentioning

confidence: 99%

“…Cyrek et al 14 compararam FAVs radiocefálicas de alto (> 200 mL/min) e baixo VF (< 200 mL/min) no intraoperatório e observaram taxas de perviedade primária e secundária significativamente mais altas nas FAVs de alto fluxo (100% e 93,15%, respectivamente) quando comparadas às de baixo fluxo (81,25% e 75%, respectivamente) em 1 ano. Outros estudos observacionais reiteram essa mesma relação entre o VF pós-operatório e a falha da FAV, encontrando pontos de corte que variam entre 160 mL/min e 300 mL/min 15 , 16 .…”

Section: Discussionunclassified

O volume de fluxo e a velocidade de pico sistólico ao ultrassom vascular com Doppler intraoperatório como preditores de perviedade precoce na fístula arteriovenosa autógena para hemodiálise

et al. 2021

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Resumo Contexto A insuficiência renal crônica é um problema de saúde pública mundial. A hemodiálise é a principal terapia renal substitutiva. As fístulas arteriovenosas (FAV) são uma possível escolha, mas apresentam altas taxas de falência. Objetivos Este estudo tem como objetivo avaliar a relação entre as variáveis hemodinâmicas ao ultrassom vascular com Doppler no intraoperatório e a perviedade precoce da FAV para hemodiálise. Métodos Tratou-se de um estudo prospectivo observacional. Os pacientes consecutivos foram submetidos a FAV com ultrassonografia vascular com Doppler em intraoperatório nos dias 1, 7, 30 e 60. Eles foram divididos em grupos quanto à presença ou não de perviedade primária e secundária, e o volume de fluxo (VF) e a velocidade de pico sistólico (VPS) foram comparados. Foram realizadas curvas receiver operating characteristic (ROC), com definição de valores de VPS e VF com sensibilidade (S) e especificidade (E). Resultados Foram analisados 47 pacientes, os quais preencheram os critérios de inclusão. Os valores de VPS e VF intraoperatório foram maiores nos pacientes com perviedade primária e secundária comparados àqueles com falência. Os seguintes valores apresentaram maiores sensibilidade e especificidade para predizer perviedade primária aos 30 dias: 106 cm/s para VPS venoso, S: 75%, E: 71,4%; e 290,5 mL/min para VF arterial, S: 80,6%, E: 85,7%. Para perviedade secundária aos 30 dias, foram observados: 106 cm/s para VPS arterial, S: 72,7%, E: 100%; e 230 mL/min para VF venoso, com S: 86,4%, E: 100%. Para a perviedade primária no 60º dia, foram observados: 106 cm/s para VPS venoso, S: 74,4%, E: 62,5%; e 290,5 mL/min para VF arterial, S: 80%, E: 75%. Conclusões A velocidade de pico sistólico e o VF ao ultrassom vascular com Doppler intraoperatório são preditores de perviedade precoce na FAV para hemodiálise.

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“…Необходимо помнить, что значительно снижение этого показателя может увеличивать риск тромбоза АВФ [59][60][61][62]. В нашем исследовании при необходимости редукции кровотока целевые значения находились в интервале 1-1,5 литра в минуту.…”

Section: Discussionunclassified

Ambiguous results of balloon angioplasty for central vein stenosis in hemodialysis patients with native arteriovenous fistula

Карданахишвили¹,

Зулькарнаев

Байков³

et al. 2020

RJTAO

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Post‐operative arterio‐venous fistula blood flow influences primary and secondary patency following access surgery

Cited by 10 publications

References 30 publications

The feasibility of small-caliber veins for autogenous arteriovenous fistula creation: A single-center retrospective study

The feasibility of small-caliber veins for autogenous arteriovenous fistula creation: A single-center retrospective study

O volume de fluxo e a velocidade de pico sistólico ao ultrassom vascular com Doppler intraoperatório como preditores de perviedade precoce na fístula arteriovenosa autógena para hemodiálise

Ambiguous results of balloon angioplasty for central vein stenosis in hemodialysis patients with native arteriovenous fistula

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