Determinants of successful arteriovenous fistulae creation including intraoperative transit time flow measurement

2019 ◽  
Vol 21 (3) ◽  
pp. 387-394 ◽  
Author(s):  
Alexander Meyer ◽  
Eberhard Flicker ◽  
Sascha T König ◽  
Anne Sabine Vetter
Keyword(s):  
Blood Flow ◽  
Physical Examination ◽  
Arteriovenous Fistula ◽  
Transit Time ◽  
Predictive Value ◽  
Flow Measurement ◽  
Arteriovenous Fistulae ◽  
Time Flow ◽  
First Choice ◽  
Fistula Maturation

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: The intraoperative measurement of the blood flow in the outflow vein has been identified as the unique significant parameter for the fistula maturation. Conclusion: The predictive value of intraoperative flow measurement is superior to intraoperative physical examination and could help reduce the fistula dysmaturation rate. Intraoperative transit time flow measurement is an easy method and can be used to predict successful fistula maturation in a high percentage rate.

Intraoperative use of transit time flow measurement improves patency of newly created radiocephalic arteriovenous fistulas in patients requiring hemodialysis

2020 ◽  
Vol 21 (6) ◽  
pp. 990-996
Author(s):  
Anna E Cyrek ◽  
Johannes Bernheim ◽  
Benjamin Juntermanns ◽  
Peri Husen ◽  
Arkadius Pacha ◽  
...  
Keyword(s):  
Blood Flow ◽  
Arteriovenous Fistula ◽  
Transit Time ◽  
Intraoperative Ultrasound ◽  
Low Flow ◽  
Flow Measurements ◽  
Technical Problems ◽  
Arteriovenous Fistulas ◽  
Time Flow ◽  
Observation Period

Background: The autologous arteriovenous fistula is the primary choice to establish hemodialysis access without high failure rates. Intraoperative ultrasound flow measurements of newly created autologous arteriovenous fistulas represent a possibility of quality control and may therefore be a tool to assess their functionality. The aim of our study was to correlate intraoperative blood flow with access patency. Methods: Between March 2012 and March 2015, intraoperative transit time flow measurements were collected on 89 patients. Measurements were performed 5–10 min after the creation of a standardized anastomosis using 3–6 mm flow probes. To examine the correlation between intraoperative blood flow and access patency, groups of patients with high (> 200 mL/min) versus low flow (< 200 mL/min) were enrolled. Patients were assessed clinically and with ultrasound every 3 months. Data were analyzed retrospectively. Results: In the current short-term follow-up, including 89 patients (age 62 ± 3 years), 61 (68.5%) of the autologous arteriovenous fistulas were currently being used in an observation period ranging from 3 months to 3 years (mean observation period 546 ± 95 days) postoperatively. The intraoperative blood flow in patients with functioning autologous arteriovenous fistula (78) was significantly higher than that of patients without functioning autologous arteriovenous fistulas (407 ± 25 vs 252 ± 42 mL/min, respectively; p < 0.005) (11). Conclusion: The intraoperative measurement of blood flow is a useful tool to predict the outcome of maturation in autologous arteriovenous fistula. With this method, technical problems can be detected and corrected intraoperatively. Routine implementation of intraoperative flow measurements has to be examined by prospective controlled trials.

scholarly journals Transit time flow measurement in patients with diffuse coronary artery disease during coronary artery bypass grafting

2020 ◽  
pp. 22-27
Author(s):  
А.А. Ширяев ◽  
Д.М. Галяутдинов ◽  
В.П. Васильев ◽  
В.Ю. Зайковский ◽  
Ш.Д. Мукимов ◽  
...  
Keyword(s):  
Blood Flow ◽  
Coronary Artery ◽  
Transit Time ◽  
Flow Measurement ◽  
Bypass Surgery ◽  
Coronary Bypass ◽  
Coronary Bypass Surgery ◽  
Graft Occlusion ◽  
Time Flow

Диффузное поражение (ДП) коронарных артерий (КА) — одна из наиболее сложных ситуаций с прогностической точки зрения для выполне- ния операции коронарного шунтирования (КШ). Протяженное коронарное поражение является фактором риска интраоперационной несо- стоятельности и окклюзии шунта в отдаленном периоде. Проведен анализ 14 ретроспективных и 1 рандомизированного исследования приме- нения интраоперационной ультразвуковой флоуметрии при КШ. Ультразвуковая флоуметрия в настоящее время эффективно используется для качественной и количественной оценки кровотока в шунтах КА и, таким образом, позволяет снизить количество технических ошибок при оперативных вмешательствах и улучшить отдаленный прогноз пациентов. При ДП КА часто отмечаются относительно невысокие показатели кровотока по шунтам, а их прогностическое значение для различных трансплантатов однозначно не определено Diffuse lesion (DL) of the coronary arteries (CA) is one of the most difficult situations from a prognostic point of view for performing coronary bypass surgery. The extent of the lesion and the presence of antegrade blood flow are risk factors for intraoperative failure and graft occlusion in the long-term period. The analysis of 14 retrospective and 1 randomized study of the use of intraoperative ultrasound flowmetry or TTFM (transit time flow measurement) for coronary bypass surgery was performed. TTFM is currently effectively used for qualitative and quantitative assessment of blood flow in CA bypass grafts and thus reduces the number of technical errors during surgical interventions and improves the long-term prognosis of patients. At the same time, relatively low blood flow rates for shunts are often observed in CA DL, and their prognostic value for various transplants is not clearly defined

scholarly journals The predictive value of intraoperative transit-time flow measurement parameters for early graft failure in different target territories

2021 ◽  
Vol 77 (2) ◽  
pp. 201-205 ◽  
Author(s):  
Guodong Zhang ◽  
Zhou Zhao ◽  
Zengqiang Han ◽  
Qing Gao ◽  
Jing Liu ◽  
...  
Keyword(s):  
Transit Time ◽  
Predictive Value ◽  
Graft Failure ◽  
Flow Measurement ◽  
Time Flow ◽  
Early Graft ◽  
Early Graft Failure

Blood flow assessment by transit time flow measurement and its prognostic impact in coronary bypass surgery

2020 ◽  
Vol 61 (3) ◽  
Author(s):  
Lars Niclauss ◽  
Pier-Giorgio Masci ◽  
Anna G. Pavon ◽  
David Rodrigues ◽  
Juerg Schwitter
Keyword(s):  
Blood Flow ◽  
Transit Time ◽  
Flow Measurement ◽  
Bypass Surgery ◽  
Coronary Bypass ◽  
Coronary Bypass Surgery ◽  
Prognostic Impact ◽  
Time Flow

scholarly journals Predictive value of intraoperative transit-time flow measurement for short-term graft patency in coronary surgery

2006 ◽  
Vol 132 (3) ◽  
pp. 468-474 ◽  
Author(s):  
Gabriele Di Giammarco ◽  
Marco Pano ◽  
Sergio Cirmeni ◽  
Piero Pelini ◽  
Giuseppe Vitolla ◽  
...  
Keyword(s):  
Transit Time ◽  
Predictive Value ◽  
Flow Measurement ◽  
Graft Patency ◽  
Coronary Surgery ◽  
Short Term ◽  
Time Flow

scholarly journals The application of intraoperative transit time flow measurement to accurately assess anastomotic quality in sequential vein grafting

2013 ◽  
Vol 17 (6) ◽  
pp. 938-943 ◽  
Author(s):  
Yang Yu ◽  
Fan Zhang ◽  
Ming-Xin Gao ◽  
Hai-Tao Li ◽  
Jing-Xing Li ◽  
...  
Keyword(s):  
Transit Time ◽  
Flow Measurement ◽  
Time Flow

Roles of Transit-Time Flow Measurement for Coronary Artery Bypass Surgery

2018 ◽  
Vol 66 (06) ◽  
pp. 426-433 ◽  
Author(s):  
Yasushi Takagi ◽  
Yoshiyuki Takami
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Transit Time ◽  
Graft Failure ◽  
Flow Measurement ◽  
Coronary Artery Bypass Surgery ◽  
Coronary Circulation ◽  
Artery Bypass ◽  
Flow Characteristics ◽  
Time Flow

AbstractTransit-time flow measurement (TTFM) has been increasingly applied to detect graft failure during coronary artery bypass grafting (CABG), because TTFM is less invasive, more reproducible, and less time consuming. Many authors have attempted to validate TTFM and to gain the clear cutoff values and algorithm in TTFM to predict graft failure. The TTFM technology has also been shown to be a useful tool to investigate CABG graft flow characteristics and coronary circulation physiology. It is important to recognize the practical roles of TTFM in the cardiac operating room by review and summarize the literatures.

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