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Publications
Is intra-operative blood flow predictive for early failure of radiocephalic arteriovenous fistula?
Background: For over 50 years, radiocephalic wrist arteriovenous fistulae (RCAVF) have been the primary and best vascular access for haemodialysis. Nevertheless, early failure due to thrombosis or non-maturation is a major complication resulting in their abandonment. This prospective study was designed to investigate the predictive value of intra-operative blood flow on early failure of primary RCAVF before the first effective dialysis.
Methods: We enrolled patients undergoing creation of primary RCAVF for haemodialysis based on the preoperative ultrasound vascular mapping discussed in a multi-disciplinary approach.
Intraoperative blood flow measurement was systematically performed once the anastomosis had been completed using a transit-time ultrasonic flowmeter. During the follow-up, blood flow was estimated by colour flow ultrasound at various intervals. Any events related to the RCAVF were recorded.
Results: Read more...
Obesity-related decrease in intra-operative blood flow is associated with maturation failure of radiocephalic arteriovenous fistula
Objective: Successful arteriovenous fistula (AVF) maturation is often challenging in obese patients. Optimal initial intraoperative blood flow (IOBF) is essential for adequate AVF maturation. This study was conducted to elucidate the effect of obesity on IOBF and radiocephalic AVF maturation.
Methods: Patients with a newly created radiocephalic AVF were included (N=252). Obesity was defined as a baseline body mass index (BMI) >25 kg/m2, and primary maturation failure was defined as failure to use the AVF successfully by 3 months after its creation. IOBF was measured immediately after construction of the AVF with a VeriQTM system (Medistim, Oslo, Norway).
Results: Read more...
Determinants of successful arteriovenous fistulae creation including intraoperative transit time flow measurement
Background: The prevalence of hemodialysis patients is increasing, and it is important to create the arteriovenous fistula as early as possible to avoid hemodialysis by central venous catheter. International guidelines recommend arteriovenous fistula as the vascular access of first choice. Arteriovenous fistulae are associated with a failure rate of 23%. The success of an arteriovenous fistula can be evaluated intraoperatively by physical examination and by measuring the blood flow.
Objectives: The aim of the study is to describe the predictive value of various factors for fistula maturation in the context to the current literature.
Methods: We report on a prospective cohort study of 41 patients, undergoing a primary arteriovenous fistula at the upper extremity. The primary endpoint of the study was the successful fistula maturation after 6 weeks.
Results: Read more...
2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization
