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Transit Time Flowmetry and Vein Size Are Predictive of Arteriovenous Fistula Maturation

Huh Up, Cho Young-Jong, 강필제, 조원철,
소속 상세정보
 ( Huh Up ) - University of Ulsan College of Medicine Asan Medical Center Department of Thoracic and Cardiovascular Surgery
 ( Cho Young-Jong ) - University of Ulsan College of Medicine Gangneung Asan Hospital Department of Radiology
강필제 ( Kang Pil-Je ) - University of Ulsan College of Medicine Asan Medical Center Department of Thoracic and Cardiovascular Surgery
조원철 ( Cho Won-Chul ) - University of Ulsan College of Medicine Gangneung Asan Hospital Department of Thoracic and Cardiovascular Surgery

Abstract


Background: This study aimed to assess the effect of vessel size and flow characteristics on the maturation of autogenous radiocephalic arteriovenous fistulae (RCAVFs).

Methods: We retrospectively reviewed records of patients undergoing RCAVF creation at a single medical center from January 2013 to December 2019. Operative variables were compared between patients whose fistulae matured and those whose fistulae failed to mature.

Results: Overall, 152 patients (33 of whom were women) with a mean age of 62.6±13.6 years underwent RCAVF creation; functional maturation was achieved in 123. No statistically significant differences were observed between patients in whom maturation was or was not achieved in terms of the following variables: female sex (20.3% vs. 25.0%), radial artery size (2.5 vs. 2.4 mm), and pulsatility index (0.69 vs. 0.62). Low intraoperative transit time flowmetry (TTF; 150.4 vs. 98.1 mL/min) and small vein size (2.4 vs. 2.0 mm) were associated with failure of maturation. The best cutoff diameter for RCAVF TTF and cephalic vein size were 105 mL/min and 2.45 mm, respectively.

Conclusion: In patients who undergo RCAVF creation, vein diameter on preoperative ultrasonography and intraoperative TTF are predictors of functional maturation. We identified an intraoperative TTF cutoff value that can be used for intraoperative decision-making.

키워드

Arteries; Veins; Fistula

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