title: Hemodialysis access-induced ischemia is not related to configuration and access flow rates of upper arm arteriovenous fistulas at the elbow.
abstract: BACKGROUND
  The purpose of the study was to find a relationship between the configuration of autogenous upper arm arteriovenous fistulas (AVFs) at the elbow and high access flow rates.
  
  
  METHODS
  Forty-seven patients with well-functioning autogenous upper arm AVFs at the elbow were included. The configuration of the AVF and access flow rate was determined by duplex scanning.
  
  
  RESULTS
  Hemodialysis access-induced distal ischemia scores and access flow rates were comparable in AVFs with 1 or 2 efferent veins (1829.9 ± 1121.3 mL/min, range [400-5000] vs. 1988.5 ± 1324.5 mL/min, range [130-5000]; P = 0.61). The basilic vein had statistically significant larger diameters than the cephalic vein (8.1 ± 2.7 mm, range [2.7-11.0] vs. 5.8 ± 2.5 mm, range [3.8-13.0]; P = 0.02), but no statistically significant difference in flow rates were observed (1884.5 ± 889.0 mL/min, range [824-3600] vs. 1130.0 ± 1258.4 mL/min, range [400-5000]; P = 0.53). Access flow rates were higher in AVFs with the brachial artery as afferent artery than when the radial artery was used (1909.5 ± 1273.2 mL/min, range [550-5000] vs. 1188.6 ± 642.7 mL/min, range [130-2800]; P = 0.02).
  
  
  CONCLUSIONS
  There is no difference in access flow rates in autogenous AVFs at the elbow with 1 or 2 efferent veins. Autogenous AVFs at the elbow on the radial artery have lower access flow rates than AVFs on the brachial artery.
authors: Department of Vascular Surgery, KU Leuven - University of Leuven, University Hospitals Leuven, Leuven, Belgium.
authors: Karen
authors: K
authors: Peeters
authors: Department of Radiology, KU Leuven - University of Leuven, University Hospitals Leuven, Leuven, Belgium.
authors: Sam
authors: S
authors: Heye
authors: Department of Radiology, KU Leuven - University of Leuven, University Hospitals Leuven, Leuven, Belgium.
authors: Liesbeth
authors: L
authors: Dewever
authors: Department of Nephrology, KU Leuven - University of Leuven, University Hospitals Leuven, Leuven, Belgium.
authors: Kathleen
authors: K
authors: Claes
authors: Department of Vascular Surgery, KU Leuven - University of Leuven, University Hospitals Leuven, Leuven, Belgium. Electronic address: Inge.Fourneau@uzleuven.be.
authors: Inge
authors: I
authors: Fourneau
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D001783:Blood Flow Velocity; D001916:Brachial Artery / Q000503:physiopathology / Q000601:surgery*; D004550:Elbow / Q000098:blood supply*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D017534:Radial Artery / Q000503:physiopathology / Q000601:surgery*; D012039:Regional Blood Flow; D006435:Renal Dialysis; D012307:Risk Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D055815:Young Adult