title: Routine preoperative venous and arterial mapping increases both, construction and maturation rate of upper arm autogenous arteriovenous fistulae.
abstract: OBJECTIVE
  To test the hypothesis that routine preoperative mapping and transposed brachial-basilic vein fistula (TBBVF) increases arteriovenous fistulae (AVFs) construction rates, without altering maturation rate.
  
  
  METHODS
  Over a 4-year period, 709 vascular accesses were performed, including 467 AVFs (radial-cephalic fistula [RCF], n = 217, brachial-cephalic fistula [BCF], n = 139, TBBVF, n = 111) and 251 prosthetic grafts. During the last 2 years, preoperative mapping was performed routinely by means of ultrasound, and TBBVFs were preferentially used over arteriovenous grafts (AVGs).
  
  
  RESULTS
  Over the study, construction rate of upper arm AVF increased significantly from 12% to 53% and use of prosthetic grafts decreased from 55% to 19% (P < .001). Maturation rate of RCFs, BCFs, and TBBVFs during the first part of the study was 75%, 50%, and 30% (P = .003), compared to 79%, 82%, and 86% (P = .43), respectively, during the second part.
  
  
  CONCLUSIONS
  Routine preoperative upper extremity mapping with ultrasound increases not only AVF construction rate, but also their maturation likelihood.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Henry Ford Hospital, Detroit, MI, USA.
authors.forename: Stavros K
authors.initials: SK
authors.lastname: Kakkos
authors.forename: Georges K
authors.initials: GK
authors.lastname: Haddad
authors.forename: Amalia
authors.initials: A
authors.lastname: Stephanou
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Haddad
authors.forename: Alexander S
authors.initials: AS
authors.lastname: Shepard
mesh_terms: D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000601:surgery; D016121:Brachiocephalic Veins / Q000000981:diagnostic imaging / Q000601:surgery; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008824:Michigan; D008875:Middle Aged; D016017:Odds Ratio; D017534:Radial Artery / Q000000981:diagnostic imaging / Q000601:surgery; D006435:Renal Dialysis; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D034941:Upper Extremity / Q000098:blood supply*