Dialysis fistulae patency and preoperative diameter ultrasound measurements.
BACKGROUND
This study was designed to investigate the possibility of defining a vascular diameter with a practical cut-off point, which predicts a successful patency for radiocephalic arteriovenous fistulae in dialysis patients.


METHODS
This is a retrospective analysis of prospectively gathered data. Consecutive patients (n=148) with chronic renal failure, needing vascular access for haemodialysis, were included if they underwent duplex ultrasound examination to evaluate preoperatively the vascular status and diameters for radiocephalic arteriovenous fistulae (RCAVF) construction. The associations between the diameter of the radial artery and cephalic vein and primary failure at six weeks, primary and secondary patency at one year were investigated.


RESULTS
There was no significant association between either radial artery diameter or dilated cephalic vein diameter and primary failure. There was an association between radial artery diameter and primary patency (Overall P=0.042). Males had a significantly larger mean radial artery diameter than females (P=0.005). Gender did not influence primary patency.


CONCLUSIONS
We recommend using radial artery diameters of > or = 2.1 mm and < or = 2.5 mm for RCAVF construction, this diameter category having the highest patency at 1 year. A single cut-off guideline cannot be recommended.
Korten
E
E
Department of Non-Invasive Vascular Diagnostics, Vascular Centre, Saint Franciscus Hospital Rotterdam, Rotterdam, The Netherlands. e.korten@sfg.nl
Toonder
I M
IM
Schrama
Y C
YC
Hop
W C J
WC
van der Ham
A C
AC
Wittens
C H A
CH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000098:blood supply*; D001166:Arteriovenous Shunt, Surgical; D016121:Brachiocephalic Veins / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D011300:Preoperative Care; D016016:Proportional Hazards Models; D017534:Radial Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D006435:Renal Dialysis / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014654:Vascular Patency