Simulated hemodynamic comparison of arteriovenous fistulas

Haemodialysis Access-induced Distal Ischaemia (HAIDI) is Caused by Loco-regional Hypotension but not by Steal

“…16 One model investigating pressure characteristics in proximity to the AVF found that arterial pressure was lowest in the 1-cm portion just distal to the AVF ('pressure sink'). 17,18 A 100-mmHg arteriovenous difference was observed between systolic arterial (150 mmHg) and venous (50 mmHg) legs of human radiocephalic (RC) AVFs. This pressure fall was thought due, in part, to severe fluid energy loss associated with a disturbed flow pattern in the anastomotic area.…”

Upper Extremity Ischemia and Hemodialysis Vascular Access

“…In radiocephalic AVFs, bloodflow may amounts 500 -800 cc/min and this increases in AVF with large calibre arteries. 6 In AVFs with the anastomosis to the axillary or brachial artery (brachio cephalic/basilic AVF; thorax and crossover loop graft) the flow may increase in time to more than 2 l/min (Tables 1 and 2). However, with an adequate collateral circulation, digital pressures usually remain sufficient enough to avoid ischemia (.…”