Hemodynamic changes in the early phase of artificially created arteriovenous fistula: color Doppler ultrasonographic findings.

Mahmutyazıcıoğlu, Kamran; Kesenci, M; Fítöz, Suat; Buyukberber, S; Şencan, Orhan; Erden, İlhan

doi:10.7863/jum.1997.16.12.813

Cited by 15 publications

(10 citation statements)

References 4 publications

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“…This trend was similar to those reported in previous studies. [6,8] However, our follow-up was extended to 6 months, and we observed that the native radiocephalic fistula continued to mature until the last follow-up examination. Some authors recommend the early use of arteriovenous fistulae, [4,5] but the K/DOQI guideline recommends that new arteriovenous fistula be punctured after a period of at least 1 but preferably 3 to 4 months.…”

Section: Discussionmentioning

confidence: 86%

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Ultrasonographic Maturation of Native Arteriovenous Fistulae: A Follow-Up Study

et al. 2007

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Background/aims. Ideal time needed for arteriovenous fistula (AVF) maturation is still controversial. In this study, we aimed to investigate the natural course of AVF maturation and also investigated the factors affecting AVF maturation. Methods. We studied 31 (21M/10F, mean age 55.8 ± 16.2) chronic renal failure patients. We evaluated the patients with color Doppler ultrasound examination before the fistula operation, at the first day, and at the first, second, third, and sixth months. Radial artery (RA) diameter, flow velocity, flow, resistance index, fistula vein diameter, flow velocity, and flow were measured. Results. Patency rates at the first post-operative day and the sixth month were 87.1% and 67.1%, respectively. Cephalic vein flow was 451.2 ± 248.6 mL/min at the first month and 528.6 ± 316.5 mL/ min at the sixth month. Baseline RA diameter was lower in failing fistulas than that of patent fistulas. Failing fistulas were more common in women. Conclusion. Blood flow was enough for hemodialysis at the end of the first month. However, fistula maturation had continued until the end of the study; women and patients with low RA diameter are particularly prone to fistula failure. Therefore, especially in these patients, AVF must be created at least three or four months before the predicted hemodialysis initiation time.

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Section: Discussionmentioning

confidence: 86%

“…[4] However, few studies with limited follow-up times had examined the course of AVF maturation. [6][7][8][9] The aim of this prospective study is to evaluate the natural course of AVF maturation using Doppler ultrasound and examine the factors that can affect AVF maturation.…”

Section: Introductionmentioning

confidence: 99%

Ultrasonographic Maturation of Native Arteriovenous Fistulae: A Follow-Up Study

et al. 2007

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“…1,3,4 Although many of those studies examined both arteries and veins, none has shed light on the comparison of success rates between the intraoperative thrill noted by the surgeons and the CDUS findings. Mahmutyazicioglu and colleagues 5 have documented a study in which CDUS was used in evaluating the postoperative hemodynamic changes in the RA. Malovrh 1 reported on the preoperative assessment of the internal diameter and the Doppler flow signals in the RA by duplex sonography.…”

Section: Discussionmentioning

confidence: 99%

Cephalic vein and hemodialysis fistula: surgeon's observation versus color Doppler ultrasonographic findings.

Mihmanlı

Beşirli

Kuruğoğlu

et al. 2001

J of Ultrasound Medicine

102

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The aim of this study was to evaluate whether preoperative color Doppler ultrasonography improves immediate success rates of arteriovenous fistulas for dialysis. One hundred twenty-four patients with chronic renal failure underwent color Doppler ultrasonographic examination of both arms, including the cephalic vein, before arteriovenous fistula construction. Patients were randomly divided into 2 groups: A and B. In group A, there were 52 patients, and the surgeon planned to construct arteriovenous fistulas depending only on physical examination. In group B, which comprised 72 patients, surgeons performed arteriovenous fistula construction on sites labeled by color Doppler ultrasonography. In group A, of 52 patients who had surgery for arteriovenous fistula construction, 13 had fistulas that did not function. Among these 13 patients, 8 were found to have chronic thrombotic changes in the cephalic vein on color Doppler ultrasonography, and 5 had none of these changes. When we checked the color Doppler ultrasonographic findings, we noted that these 5 patients had decreased volume flow in the radial artery. On the whole, the arteriovenous fistulas worked in 39 patients (75%) and did not function in 13 patients (25%). In group B, surgeons followed the color Doppler ultrasonographic results. Of 72 patients who underwent the procedure, 68 patients (94.4%) had functioning fistulas, whereas 4 (5.6%) had fistulas that did not work. These 4 patients were found to have low volume flow in the radial artery. When both groups were compared by chi2 analysis, the difference was statistically significant (P = .002). Group B, in which patients were preoperatively evaluated by color Doppler ultrasonography, had a high success rate. We found that color Doppler ultrasonography is very helpful as a noninvasive procedure for this evaluation. Although many surgical clinics still perform arteriovenous fistula construction without the aid of color Doppler ultrasonographic findings, we think that the use of color Doppler ultrasonography should be emphasized before surgeons proceed with arteriovenous fistula construction.

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“…Connecting a high-pressure artery to a low-pressure vein often causes arterial and venous dilation and substantially increased blood flow in the new circuit. Early AVF development by using ultrasonographic (US) diameter and flow measurements has only been described in small, singlecenter studies (1)(2)(3)(4). Publications have focused on forearm AVF, with relatively little quantitative data reported on upper-arm AVFs, a common site of AVF placement in the United States.…”

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confidence: 99%