First-week Postoperative Flow Measurements are Highly Predictive of Primary Patency of Radiocephalic Arteriovenous Fistulas
| Autor: | Eric D. Ladenheim, Nathan Chadwick, Siddhartha Agrawal, Dzenan Lulic, Craig Lum |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent Treatment outcome 030232 urology & nephrology Arteriovenous fistula Kaplan-Meier Estimate 030204 cardiovascular system & hematology Veins Upper Extremity Young Adult 03 medical and health sciences Arteriovenous Shunt Surgical 0302 clinical medicine Predictive Value of Tests Renal Dialysis Risk Factors medicine.artery medicine Humans Vascular Patency Radial artery Early failure Aged Proportional Hazards Models Retrospective Studies Aged 80 and over Ultrasonography Doppler Duplex business.industry Graft Occlusion Vascular Retrospective cohort study Middle Aged medicine.disease Surgery Treatment Outcome Postoperative visit Regional Blood Flow Nephrology Predictive value of tests Radial Artery Female business Blood Flow Velocity |
| Zdroj: | The Journal of Vascular Access. 17:307-312 |
| ISSN: | 1724-6032 1129-7298 |
| DOI: | 10.5301/jva.5000544 |
| Popis: | Purpose This study was conducted to determine whether volume flow rate at the first postoperative visit could predict early failure of radiocephalic arteriovenous fistulas (RCAVFs). Methods We retrospectively studied the records of 264 patients who received a RCAVF between 2007 and 2013 at our centers. Data collected included patient demographics, medical history, arterial and venous mapping, and volume flow rate intraoperatively after fistula creation but before closing the surgical incision. An intraoperative flow rate >100 mL/minute was targeted. We measured volume flow at the first postoperative visit 1 week after surgery and thereafter as needed. Results Intraoperative flow was not a significant predictor of primary patency (p = 0.44) but flow at the first postoperative visit was a statistically significant predictor of fistula primary patency (p = 0.002). No fistula with a blood flow Conclusions Flow rate at the 1-week postoperative visit was the most important predictor of RCAVF patency. Thus, it should be possible to identify patients who would benefit from early intervention or closer follow-up as soon as the first postoperative visit. This should help reduce the use of bridging hemodialysis catheters and minimize the risks of catheter dependency. |
| Databáze: | OpenAIRE |
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