scholarly journals Evaluation of hemodynamic impact of absorbable sutures in native arteriovenous fistulas: A retrospective study

2019 ◽  
Vol 43 (1) ◽  
pp. 58-61
Author(s):  
Savino Occhionorelli ◽  
Fabio Fabbian ◽  
Yuri Battaglia ◽  
Tommaso Miccoli ◽  
Dario Andreotti ◽  
...  
Keyword(s):  
Blood Flow ◽  
Arteriovenous Fistula ◽  
Flow Rate ◽  
Neointimal Hyperplasia ◽  
Blood Flow Rate ◽  
Absorbable Suture ◽  
Absorbable Sutures ◽  
The Mean ◽  
Fistula Maturation ◽  
Arteriovenous Fistula Maturation

One of the major causes of arteriovenous fistula failure is the venous stenosis due to aggressive neointimal hyperplasia. The aim of the study was to assess the arteriovenous fistula maturation comparing absorbable sutures and non-absorbable ones in native vessels. Surgeries performed during a period of 24 months by a single team of expert surgeons were evaluated. Surgeries that met the inclusion criteria, namely, age ⩾ 18 years and radio-cephalic arteriovenous fistula, were considered. According to type of suture, patients were classified as Max group (absorbable suture) and Prol group (non-absorbable). Data pertaining to 70 patients were collected; 51% were men and the mean age was 73 ± 12 years. In Max group, an increasing blood flow was observed during the first 4 weeks without post-operative complications. In Prol group, six patients had thrombosis that resulted in vascular access failure. After the first week, the duplex Doppler ultrasound of both groups showed a regular arteriovenous fistula maturation, with an increase of blood flow rate. Although pre-operative post-tourniquet mean vein diameters of Max group were not adequate, the mean vein diameter and mean blood flow rate increased after 4 weeks, respectively. On the contrary, in Prol group, mean vein diameters and blood flow rate decreased. The maturation of arteriovenous fistula and its functional performance were not altered by the type of suture (absorbable/non-absorbable). Absorbable sutures were associated with good results considering arteriovenous fistula maturation.

scholarly journals P1367THE RELATIONSHIP OF SERUM PHOSPHORUS LEVEL AND ARTERIOVENOUS FISTULA DYSFUNCTION IN MAINTENANCE HEMODIALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Hyung-Jong Kim ◽  
Mi Jung Lee
Keyword(s):  
Blood Flow ◽  
Risk Factor ◽  
Arteriovenous Fistula ◽  
Flow Rate ◽  
Vascular Access ◽  
Univariate Analysis ◽  
Blood Flow Rate ◽  
Dialysis Unit ◽  
The Mean ◽  
The Impact

Abstract Background and Aims It is known that maintenance of function of arteriovenous fistula (AVF) is very important in the management of hemodialysis (HD) patients. Therefore, identifying a risk factor for decreased vascular access flow has a clinical relevance in real world practice. Although hyperphosphatemia plays a crucial role in the pathogenesis of vascular calcification, there is lack of studies evaluating the effect of hyperphosphatemia on AVF. This study investigated the impact of serum phosphorous (P) on vascular access flow in HD patients. Method Sixty-two maintenance HD patients who visited dialysis unit of Bundang CHA Medical Center from November 2016 to December 2017 were included in this study. Serum P levels were determined every month and time-averaged serum P was calculated. All patients had left arm AVF (side to side anastomosis) and vascular access flow was assessed by Transonic HD 03. Decreased vascular access flow was defined as less than 600 mL/min. Results The mean age was 57.9 ± 12.1 years, 32 patients (51.6%) were men. The mean serum P levels were 5.1 ± 1.1 mg/dL and the vascular access flow was 1,071.4 ± 504.2 mL/min. Decreased vascular access flow was observed in 14 of 62 patients (22.6%). In univariate analysis, higher serum P was significantly associated with decreased vascular access flow (odds ratio [OR]=2.089, 95% confidence interval [CI]=1.159-3.766, P=0.014). But there was no significant association of dialysis blood flow rate, ejection fraction on echocardiography and serum calcium (Ca) levels with vascular access flow. Multivariable analysis indicated that higher serum P was independently associated with greater risk of decreased vascular access flow (OR=4.012, 95% CI=1.651-9.711, P=0.002). Old age, reduced EF, low dialysis blood flow rate and higher serum Ca was not associated with vascular access flow. Conclusion This study demonstrated that higher serum P was the independent risk factor for decreased vascular access flow in maintenance HD patients. Serial monitoring of serum P may be helpful to stratify the risk of vascular access dysfunction in these patients.

Abstract 312: Mapping the Inflammatory Macrophage Response during Arteriovenous Fistula Maturation by In Vivo Molecular Imaging

2013 ◽  
Vol 33 (suppl_1) ◽  
Author(s):  
Jie Cui ◽  
Chase W Kessinger ◽  
Jason R McCarthy ◽  
Charles Lin ◽  
Farouc A Jaffer
Keyword(s):  
Molecular Imaging ◽  
Arteriovenous Fistula ◽  
Neointimal Hyperplasia ◽  
Critical Role ◽  
Anastomotic Site ◽  
Macrophage Response ◽  
Fistula Maturation ◽  
Arteriovenous Fistula Maturation ◽  
Inflammatory Macrophage

Introduction Inflammation plays a critical role in neointimal hyperplasia (NH), which leads to arteriovenous fistula (AVF) failure in hemodialysis patients. However, the spatial distribution of macrophages in vivo post AVF creation remains unclear. In this study, we mapped the distribution of macrophages in AVF using intravital fluorescence microscopy (IVFM) and a fluorescence macrophage nanosensor, CLIO-VT680. We hypothesized that the intensity of CLIO-VT680 signals would illuminate the topography of AVF inflammation. Methods AVF was created in C57BL/6J mice (n=5) by end to side anastomosis between the jugular vein and the ipsilateral carotid artery. Mice were injected with CLIO-VT680 (10mg/kg) at day 13 post AVF creation and imaged by IVFM 24 hours later. AVF was resected at week 6, and Von Gieson (VVG) staining was performed. Mean CLIO signal intensity (MSI) was measured every 60μm from the anastomosis. Target to background ratios (TBRs) were calculated as the MSI of AVF divided by the MSI of the control artery. TBR ratio was calculated by the TBRs at different distance away from the anastomosis divided by the TBR at the anastomotic site. Results The survival rate of mice after AVF creation was 100%. The penetration depth of IVFM was 200μm. IVFM detected significantly higher TBRs of CLIO signals near the anastomotic site (p<0.05). There is a linear relationship between TBR ratios and the distance away from the anastomosis (R2=0.99). VVG staining of resected AVF showed the volume of NH decreased as the distance away from the anastomosis increased. Conclusion Macrophages response can be detected via CLIO-VT680 using IVFM. In vivo molecular imaging may be able to predict AVF failure.

Influence of Peripheral Blood Flow Parameters on the Terms of Arteriovenous Fistula Maturation

Flebologiia ◽  
2020 ◽  
Vol 14 (1) ◽  
pp. 25
Author(s):  
A. A. Repin ◽  
P. F. Kravtsov ◽  
S. E. Katorkin ◽  
M. A. Melnikov ◽  
Yu. B. Reshetnikova
Keyword(s):  
Blood Flow ◽  
Arteriovenous Fistula ◽  
Peripheral Blood ◽  
Peripheral Blood Flow ◽  
Flow Parameters ◽  
Fistula Maturation ◽  
Arteriovenous Fistula Maturation

Characteristics of non-mature but functional autogenous radiocephalic fistulas in hemodialysis patients: A prospective cohort study

2019 ◽  
Vol 21 (5) ◽  
pp. 636-645
Author(s):  
Dongliang Zhang ◽  
Zhoucang Zhang ◽  
Li Wan ◽  
Jingjing Chang ◽  
Rui Zhao
Keyword(s):  
Blood Flow ◽  
Arteriovenous Fistula ◽  
Resistance Index ◽  
Vessel Diameter ◽  
Flow Volume ◽  
Arteriovenous Fistulas ◽  
Blood Flow Volume ◽  
Fistula Maturation ◽  
Arteriovenous Fistula Maturation ◽  
Baseline Diameter

Target: To compare the ultrasound characteristics between functional, mature arteriovenous fistulas and functional, non-mature arteriovenous fistulas and to identify the predictors of arteriovenous fistula maturation in the forearm. Methods: Patients with newly set-up functional arteriovenous fistulas were enrolled in this prospective cohort study. Ultrasound examinations were conducted pre-operatively and post-operatively. The inner vessel diameter, blood flow volume, and resistance index were measured and compared between the maturation group (Group M) and non-maturation group (Group N). Baseline parameters were calculated to determine the predictors of non-maturation of arteriovenous fistulas. Results: All 52 patients with functional arteriovenous fistulas, who were categorized into Group M (25 patients, 48.08%) and Group N (27 patients, 51.92%), finished 24 weeks of follow-up after arteriovenous fistula surgery. The arteriovenous fistulas displayed a significant and rapid increase in the vessel diameter (mean increase of 1.34 times in the arteries and 1.92 times in the veins) and blood flow volume (mean increase of 9.29 times of the arteries and 43.66 times of the veins) and a decrease in the resistance index (mean decrease in 48.00% in the arteries) 8 weeks after surgery. Group N had a lesser increase in the vessel diameters (1.78 times vs 2.06 times, t = −3.136, p = 0.003) and blood flow volume (33.98 times vs 54.11 times, t = −2.383, p = 0.021) of the cephalic vein draining segments (a6) than Group M. The baseline diameter of a6 was the only independent predictor (regression coefficient = 26.229, p = 0.008) of maturation of the functional arteriovenous fistulas after correcting for sex, age, diabetes kidney disease, weight, and height. Conclusion: The baseline diameter of the cephalic vein was the only predictor of arteriovenous fistula maturation based on the pre-operative ultrasound measurements in Chinese hemodialysis patients.

scholarly journals Application of Non-thermal Commscope Irradiation in Preventing Com- plications of Hemodialysis Fistula

1970 ◽  
Vol 1 (1) ◽  
Author(s):  
Leng Hui
Keyword(s):  
Blood Flow ◽  
Blood Vessel ◽  
Arteriovenous Fistula ◽  
Flow Rate ◽  
Blood Flow Rate ◽  
Hemodialysis Patients ◽  
First Choice ◽  
Long Time ◽  
And Control

Abstract: Objective: To ensure that the patient’s treatment and control of the patient’s blood in the course of long-term dialysis, in order to ensure the blood flow rate at the rate of hemodialysis in the blood vessel of hemodialysis patients, mortality rate. Methods: In many Western countries, it has been found from the experience of long-term accumulation, arteriovenous fistula (AVF) is the first choice for long-term dialysis blood patients, which has a lot of a little bit, not only from the infection rate and blood flow, which has a lot of advantages.But its existence is also a lot of complications, non-thermal Commscope irradiation is a very effective way. Results: The method was compared with the method, and it was found that P <0.05, which was statistically significant. Conclusion: AVF is the preferred method of vascular access in patients with persistent dialysis, which is very easy to be punctured and has a very long time for maintenance. It is very important to carry out the treatment, treatment and surveillance of AVF complications and the use of means.

The effect of litter size on placental blood flow and placental calcium transfer in the multifoetate guinea-pig

1978 ◽  
Vol 39 (2) ◽  
pp. 347-356 ◽  
Author(s):  
H. W. Symonds ◽  
R. H. Bubar ◽  
W. CRACKEL ◽  
A. R. Twardock
Keyword(s):  
Blood Flow ◽  
Litter Size ◽  
Flow Rate ◽  
Transfer Rate ◽  
Placental Tissue ◽  
Blood Flow Rate ◽  
Maternal Plasma ◽  
Placental Blood ◽  
The Mean ◽  
Placental Blood Flow

1. Placental blood flow rate and calcium transfer rate were measured at 61 d of pregnancy in guinea-pigs carrying between one and eight foetuses.2. Placental blood flow rate was significantly correlated with foetal weight. Ca transfer rate was related to placental size. Irrespective of litter size the mean amount of Ca transferred across a placenta was between 0.22 and 0.34 mg/h per g placental tissue.3. It was concluded that there was a limit to the rate of transfer which was produced by a combination of limitations in placental blood flow rate, maternal plasma Ca concentration and placental tissue transfer capacity.

The relationship between arteriovenous fistula blood flow rate and pulmonary artery pressure in hemodialysis patients

2007 ◽  
Vol 40 (2) ◽  
pp. 509-513 ◽  
Author(s):  
Gursel Acarturk ◽  
Ramazan Albayrak ◽  
Mehmet Melek ◽  
Seref Yuksel ◽  
Ihsan Uslan ◽  
...  
Keyword(s):  
Blood Flow ◽  
Pulmonary Artery ◽  
Arteriovenous Fistula ◽  
Pulmonary Artery Pressure ◽  
Flow Rate ◽  
Blood Flow Rate ◽  
Hemodialysis Patients ◽  
Artery Pressure ◽  
The Relationship

scholarly journals Korelasi Blood Flow Rate Intraoperasi dan Enam Minggu Pascaoperasi Arteriovenous Fistula Brakiosefalika Dihubungkan dengan Maturitas di RSUP Prof. Dr. R. D. Kandou Manado

2019 ◽  
Vol 11 (2) ◽  
pp. 123
Author(s):  
Aubrey W. Palin ◽  
Djony E. Tjandra ◽  
Richard M. Sumangkut
Keyword(s):  
Blood Flow ◽  
Arteriovenous Fistula ◽  
Flow Rate ◽  
Significant Relationship ◽  
Blood Flow Rate ◽  
National Kidney Foundation ◽  
Av Fistula ◽  
Factors Affecting ◽  
Significant Difference ◽  
Venous Diameter

Abstract: American National Kidney Foundation (2002) states that end-stage kidney disease is an indication for renal replacement therapy, one of which is hemodialysis. Vascular access comprises a fundamental component of hemodialysis therapy (HD), facilitating the patient’s blood flow to the dialyzer. However, there are some factors affecting the maturity of an arteriovenous fistula (AVF), inter alia the patient, comorbidities, and anatomical and functional conditions of the blood vessels involving the blood flow rate (BFR). This study was aimed to establish the differences between intra-operative BFR and BFR six weeks after surgery as well as any correlations between intraoperative BFR, venous diameter, and skin to vein distance with maturity of brachiocephalic AVF. This was prospective cohort study conducted at the Department of Surgery, Prof. Dr. R. D. Kandou General Hospital Manado. Subjects were 41 CKD patients who underwent brachiocephalic AVF surgery. The vein diameter, skin to vein distance, and BFR were measured immediately as intra-operative data using a Doppler USG and all were re-measured at six-week-follow-up examination as six-week-postoperative data. The results showed that there was a significant increase in BFR at six weeks postoperation compared to intraoperation (t=-19.215; P <0.0001). Bi-serial point correlation analysis revealed that there was a significant correlation between intraoperative venous diameter and maturity (rpb=0.276; P=0.04) as well as a significant correlation between intraoperative BFR and maturity (rpb=0.615; P=0.002). No significant correlation was observed between intra-operative skin to vein distance and maturity (rpb=0.093; P=0.281). Conclusion: There was a significant difference in BFR between intraoperation and 6 weeks postoperation in the mature AV fistula. There was a significant relationship between intraoperative BFR and maturity as well as between intraoperative venous diameter and maturity, while no significant relationship between skin-vein distance and maturity was found.Keywords: brachiocephalic AVF, BFR, maturityAbstrak: American National Kidney Foundation (2002) menyatakan bahwa penderita dengan penyakit ginjal tahap akhir diindikasikan untuk dilakukan terapi pengganti ginjal, salah satunya hemodialisis (HD). Akses vaskular merupakan komponen penting pada terapi HD karena melalui akses vaskular darah dari tubuh pasien dapat dialirkan menuju dialyzer. Terdapat banyak faktor yang memengaruhi maturitas suatu arteriovenous fistula (AVF), yaitu pasien itu sendiri, komorbid, serta keadaan anatomi dan fungsional pembuluh darah termasuk nilai blood flow rate (BFR). Penelitian ini bertujuan untuk mengetahui perbedaan BFR intraoperasi dan BFR enam minggu pascaoperasi serta adanya korelasi antara BFR intraoperasi, diameter vena, dan jarak kulit-vena dengan maturitas AVF brakiosefalika. Penelitian ini dilaksanakan di Bagian Bedah RSUP Prof. Dr. R. D. Kandou Manado dengan desain kohort prospektif. Subyek penelitian ialah 41 pasien PGK yang menjalani operasi pembuatan AVF brakiosefalika. Setelah selesai operasi dihitung diameter vena, jarak kulit-vena, dan BFR sebagai data intraoperasi menggunakan USG Doppler. Penghitungan dilakukan kembali 6 miggu pascaoperasi. Hasil penelitian mendapatkan peningkatan BFR yang sangat bermakna pada enam minggu pascaoperasi dibandingkan intraoperasi (t =-19,215, P<0,0001). Dengan analisis korelasi point biserial didapatkan hubungan bermakna antara diameter vena intraoperasi dengan maturitas (rpb=0,276; P=0,04), tidak terdapat hubungan bermakna antara jarak kulit-vena intraoperasi dengan maturitas (rpb=0,093; P=0,281), dan terdapat hubungan bermakna antara BFR intraoperasi dengan maturitas (rpb=0,615; P=0,002). Simpulan: Terdapat perbedaan bermakna antara BFR intraoperasi dan BFR 6 minggu pascaoperasi pada AVF matur. Terdapat hubungan bermakna antara BFR intraoperasi dan diameter vena intraoperasi dengan maturitas namun tidak terdapat hubungan bermakna antara jarak kulit-vena dengan maturitas.Kata kunci: AVF brakiosefalika, BFR, maturitas

The effect of angioplasty of single arteriovenous fistula–associated stenosis on arteriovenous fistula blood flow rate

2020 ◽  
Vol 21 (5) ◽  
pp. 705-714 ◽  
Author(s):  
George M Nassar ◽  
Gerald Beathard ◽  
Duc T Nguyen ◽  
Edward A Graviss
Keyword(s):  
Blood Flow ◽  
Arteriovenous Fistula ◽  
Flow Rate ◽  
Rank Correlation ◽  
Inverse Correlation ◽  
Blood Flow Rate ◽  
Central Vein ◽  
Luminal Diameter ◽  
Total Group ◽  
Percutaneous Balloon

Introduction: Percutaneous balloon angioplasty of arteriovenous fistula–associated stenosis is performed for a variety of indications. Successful percutaneous transluminal angioplasty (PTA) is expected to increase in arteriovenous fistula blood flow rate (Qa). A validated approach to predicting changes in Qa based upon stenosis characteristics is not available. Methods: Three baseline parameters were determined in a group of patients with a single arteriovenous fistula–associated stenosis undergoing PTA. These were percent estimated stenosis, stenosis minimum luminal diameter, and baseline Qa. The relationship between these parameters and changes in Qa following PTA was analyzed using Spearman’s rank correlation and linear regression. Results: 113 patients (total group) were studied. Of these,106 had peripheral stenosis (total peripheral subgroup) and 7 had central stenosis. For the total group and total peripheral subgroup, a highly significant inverse correlation was seen between changes in Qa and baseline Qa. A weaker correlation was seen between changes in Qa and minimum luminal diameter, but no correlation was seen with percent estimated stenosis. A minimum luminal diameter ⩽2.0 mm was predictive of ⩾300-mL/min increases in Qa, whereas a minimum luminal diameter >4.5 mm was associated with <300-mL/min increases in Qa. PTA of Central vein stenosis was not associated with significant changes in Qa. Conclusion: Baseline Qa is the best predictor for change in Qa following PTA. Stenosis minimum luminal diameter cutoffs of ⩽2.0 and >4.5 mm are useful in predicting the magnitude of changes in Qa. Percent estimated stenosis is not predictive of change in Qa. PTA of central veins does not seem to change Qa.

Exploring correlations between anatomic characteristics of dialysis arteriovenous fistula stenosis and arteriovenous fistula blood flow rate (Qa)

2019 ◽  
Vol 21 (1) ◽  
pp. 60-65
Author(s):  
George M Nassar ◽  
Gerald Beathard
Keyword(s):  
Blood Flow ◽  
Arteriovenous Fistula ◽  
Flow Rate ◽  
Blood Flow Rate ◽  
Operating Characteristics ◽  
Weak Correlation ◽  
Luminal Diameter ◽  
Stenotic Lesion ◽  
Receiver Operating Characteristics Curve ◽  
Arteriovenous Fistula Stenosis

Background: Radiologic justification for endovascular treatment of a dialysis arteriovenous fistula circuit stenosis is currently based on ⩾50% severity. However, the clinical significance of any given stenosis is not always clear. The minimum luminal diameter of any stenotic lesion in the arteriovenous fistula circuit might exert a more predictive effect on the arteriovenous fistula blood flow rate (Qa). Methods: To investigate relationships between anatomic parameters of stenosis and Qa, this study was conducted in a cohort of patients with a variety of arteriovenous fistula stenotic lesions. The goals were to determine (1) the degree of correlation between arteriovenous fistula stenosis estimated during the procedure, and that which is measured, and (2) the correlations between two anatomic stenosis parameters (percent stenosis and stenosis minimum luminal diameter) and Qa. Results: The cohort comprised 113 patients. Only a moderate correlation between estimated and measured stenosis was seen. A correlation between measured stenosis and Qa for the whole cohort was not seen, but a weak correlation between estimated stenosis and Qa was seen. Correlations between stenosis minimum luminal diameter and Qa were superior. The superiority of stenosis minimum luminal diameter to percent stenosis in correlating with a Qa of <500 mL/h was also demonstrated by receiver operating characteristics curve analysis. Stenosis minimum luminal diameter cutoffs of ⩽2.5 mm or >4 mm seemed to have a good predictive value of Qa. Conclusions: Percent stenosis determination is fraught with uncertainty and exhibits a weak correlation with Qa. Compared with percent stenosis, the minimum luminal diameter of the stenosis demonstrates a superior correlation with Qa.

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