Outcomes of post-operative duplex ultrasound following arteriovenous fistula formation: A pragmatic single-centre experience

2019 ◽  
Vol 21 (5) ◽  
pp. 623-629
Author(s):  
Andrew TO Nickinson ◽  
Rebecca Rogers ◽  
Ahmed Elbasty ◽  
Ian Nunney ◽  
Philip C Bennett
Keyword(s):  
Confidence Interval ◽  
Arteriovenous Fistula ◽  
Duplex Ultrasound ◽  
Primary Patency ◽  
Hazard Ratio ◽  
Fistula Formation ◽  
Secondary Patency ◽  
Arteriovenous Fistulae ◽  
Standard Practice ◽  
Ultrasound Surveillance

Background: Duplex ultrasound surveillance with pre-emptive treatment of an identified stenosis is increasingly being utilised to help maintain arteriovenous fistula patency. This study aims to determine whether post-operative duplex ultrasound surveillance can improve fistula patency at 12 months and improve the proportion of ‘pre-haemodialysis’ patients commencing haemodialysis via a usable fistula. Methods: All arteriovenous fistulae formed between 1st January 2015 and 31st August 2017 in a single, tertiary vascular centre were included. Primary and secondary patency at 12 months, along with the proportion of pre-haemodialysis patients commencing haemodialysis via a usable arteriovenous fistula, were compared between the fistulae undergoing duplex ultrasound surveillance and ‘standard practice’. Results: Two hundred forty-one arteriovenous fistulae were created in 216 patients. A higher proportion of brachiobasilic transposition arteriovenous fistula and patients undergoing arteriovenous fistula creation following a previously failed access were identified in the duplex ultrasound surveillance group. Primary patency at 12 months (hazard ratio = 0.43, 95% confidence interval = 0.30–0.61, p < .001) was significantly lower in the duplex ultrasound surveillance group compared with the ‘standard practice’ group. Despite this, no difference was identified in secondary patency at 12 months (hazard ratio = 1.82, 95% confidence interval = 0.87–3.80, p = .112). No difference was also identified in the proportion of pre-haemodialysis patients starting haemodialysis with a usable arteriovenous fistula (duplex ultrasound surveillance = 65.0% vs standard practice = 77.8%; odds ratio = 0.53, 95% confidence interval 0.58–1.19, p = .279). Conclusion: Post-operative duplex ultrasound surveillance following arteriovenous fistula formation is associated with higher rates of post-operative intervention; however, this does not translate into improved secondary patency or the proportion of pre-haemodialysis patients commencing HD via their fistula.

scholarly journals Paclitaxel-assisted balloon angioplasty of venous stenosis in haemodialysis access: PAVE RCT

2021 ◽  
Vol 8 (13) ◽  
pp. 1-36
Author(s):  
Narayan Karunanithy ◽  
Emily J Robinson ◽  
Francis Calder ◽  
Anthony Dorling ◽  
Janet L Peacock ◽  
...  
Keyword(s):  
Adverse Events ◽  
Confidence Interval ◽  
Arteriovenous Fistula ◽  
Balloon Angioplasty ◽  
Target Lesion ◽  
Primary Patency ◽  
Hazard Ratio ◽  
End Points ◽  
Multiple Lesions ◽  
Secondary Outcomes

Background Reliable vascular access is essential for patients receiving haemodialysis. An arteriovenous fistula is the preferred option; however, these are prone to developing stenotic segments. These lesions are treated with angioplasty, but there is a high rate of recurrence. When the PAVE (Paclitaxel-assisted balloon Angioplasty of Venous stenosis in haEmodialysis access) trial was conceived, a number of small studies suggested that restenosis may be reduced by paclitaxel-coated balloons. Objective To test the efficacy of paclitaxel-coated balloons in arteriovenous fistulas. Design A randomised controlled trial. Setting Twenty UK centres. Participants Patients (aged ≥ 18 years) referred with a clinical indication for angioplasty of an arteriovenous fistula (212 patients in total, 106 per group). Interventions High-pressure plain balloon fistuloplasty was performed in all patients. In the intervention arm, the second component was insertion of a paclitaxel-coated balloon. In the control arm, an identical procedure was followed, but using a standard balloon. Main outcome measures The primary end point was time (days) to loss of target lesion primary patency. Secondary patency end points were time to loss of access circuit primary patency and time to loss of access circuit cumulative patency. Other secondary end points included angiographically determined late lumen loss, rate of binary angiographic restenosis, procedural success, number of thrombosis events, fistula interventions, adverse events during follow-up and patient quality of life. Results Primary analysis showed no evidence for a difference in time to end of target lesion primary patency between groups (hazard ratio 1.18, 95% confidence interval 0.78 to 1.79; p = 0.440). An adjusted secondary analysis with prespecified clinical covariates gave similar results (hazard ratio 1.11, 95% confidence interval 0.69 to 1.78; p = 0.664). Prespecified secondary outcomes included the time to intervention anywhere in the access circuit or the time until the fistula was abandoned. There were no differences in these patency-related secondary outcomes or in any other secondary outcomes, such as adverse events. Limitations The PAVE trial was not a fully blinded trial. It was impossible to ensure that treating radiologists were blinded to treatment allocation because of the appearance of the paclitaxel-coated balloon. The extent to which our findings can be generalised to patients with multiple lesions could be questioned, given the proportion randomised. However, if paclitaxel-coated balloons had been effective at a single lesion segment, then there is no plausible reason why they could not be effective in patients with multiple lesions. Conclusions There were no differences in primary or secondary outcomes. Following a plain balloon angioplasty, additional treatment with a paclitaxel-coated balloon does not provide benefit. Future work The reasons for differences between the results of the PAVE trial and of other studies deserve further analysis and consideration. Other interventions to prevent restenosis following a fistuloplasty are needed. Trial registration Current Controlled Trials ISRCTN14284759. Funding This project was funded by the Efficacy and Mechanism Evaluation programme, a Medical Research Council and National Institute for Health Research (NIHR) partnership. This will be published in full in Efficacy and Mechanism Evaluation; Vol. 8, No. 13. See the NIHR Journals Library website for further project information.

Analysis of factors for post–percutaneous transluminal angioplasty primary patency rate in hemodialysis vascular access

2020 ◽  
Vol 21 (6) ◽  
pp. 892-899
Author(s):  
Kanyu Miyamoto ◽  
Takashi Sato ◽  
Keisuke Momohara ◽  
Sumihisa Ono ◽  
Makoto Yamaguchi ◽  
...  
Keyword(s):  
Blood Flow ◽  
Confidence Interval ◽  
Arteriovenous Fistula ◽  
Percutaneous Transluminal Angioplasty ◽  
Transluminal Angioplasty ◽  
Primary Patency ◽  
Hazard Ratio ◽  
Flow Volume ◽  
Blood Flow Volume ◽  
Percutaneous Transluminal

Background: Although percutaneous transluminal angioplasty has been established as a first-line therapy for access failure in dialysis, there are few reports on primary patency after percutaneous transluminal angioplasty. We investigated factors associated with primary patency following the first percutaneous transluminal angioplasty performed after vascular access construction in patients with arteriovenous fistula, including blood flow volume before and after percutaneous transluminal angioplasty and previously reported factors. Methods: We used medical records at six dialysis centers to retrospectively identify and analyze prognostic factors for primary patency after percutaneous transluminal angioplasty in 159 patients with arteriovenous fistula who underwent initial percutaneous transluminal angioplasty after vascular access construction. Results: Multivariate analysis with the Cox proportional hazard model showed that primary patency after percutaneous transluminal angioplasty in patients with arteriovenous fistula was significantly associated with lesion length (hazard ratio, 1.76; 95% confidence interval, 1.01–3.07; P = 0.045), and blood flow volume after percutaneous transluminal angioplasty (hazard ratio, 0.71; 95% confidence interval, 0.60–0.84; P < 0.001). When blood flow volume after percutaneous transluminal angioplasty was classified into three categories, risks of outcome events defining the end of primary patency after percutaneous transluminal angioplasty were significantly lower for 400–630 mL/min (hazard ratio, 0.38; 95% confidence interval, 0.21–0.68; P = 0.001) and >630 mL/min (hazard ratio, 0.16; 95% confidence interval, 0.06–0.40; P < 0.001) compared with <400 mL/min. Conclusion: Our study showed that blood flow volume after percutaneous transluminal angioplasty is an important prognostic factor for primary patency after percutaneous transluminal angioplasty in patients with arteriovenous fistula.

WavelinQ created arteriovenous fistulas versus surgical radiocephalic arteriovenous fistulas? A single-centre observational study

2020 ◽  
Vol 21 (5) ◽  
pp. 646-651 ◽  
Author(s):  
Nicholas Inston ◽  
Aurangzaib Khawaja ◽  
Karen Tullett ◽  
Robert Jones
Keyword(s):  
Arteriovenous Fistula ◽  
Primary Patency ◽  
Fistula Formation ◽  
Secondary Patency ◽  
Matched Cohort ◽  
Single Centre ◽  
Arteriovenous Fistulas ◽  
Procedural Success ◽  
Using Data ◽  
Access Pathway

Purpose: Devices to permit percutaneous endovascular arteriovenous fistula formation have recently been introduced into clinical practice with promising initial evidence. As guidelines support a distal fistula first policy, the question of whether an endovascular arteriovenous fistula should be performed as an initial option is introduced. The aims of this study were to compare a matched cohort of endovascular arteriovenous fistula with surgical radiocephalic arteriovenous fistulas. Materials and methods: Using data from a prospectively collected database over a 3-year period, a matched comparative analysis was performed. Results: WavelinQ arteriovenous fistulas (group W, n = 30) were compared with radiocephalic arteriovenous fistulas (group RC; n = 40). Procedural success was high with 96.7% for group W and 92.6% for group RC. Primary patency at 6 and 12 months was greater in group W (65.5% 6mo and 56.5% 12mo) compared to group RC (53.4% 6mo and 44% 12mo) ( p = 0.69 and 0.63). Mean primary patency was significantly lower for RC (235 ± 210 days) vs W (362 ± 240 days) ( p < 0.05). Secondary patency for group W was 75.8% and 69.5% at 6 and 12 months, respectively. Secondary patency for RC was lower at 66.7% and 57.6% at 6 and 12 months, respectively. Conclusion: Outcomes of WavelinQ arteriovenous fistulas in this series are similar to published results. When compared to a contemporaneously created group of surgical fistulas, WavelinQ demonstrated superior outcomes. These data would support that WavelinQ endovascular arteriovenous fistulas may be considered as a first option in the access pathway particularly if vessels at the wrist are absent or less than ideal.

Feasibility of a 3 mm arteriotomy for brachiocephalic fistula formation

2020 ◽  
pp. 112972982095993
Author(s):  
Jeremy Crane ◽  
Safa Salim ◽  
Rowland Storey
Keyword(s):  
Arteriovenous Fistula ◽  
Primary Patency ◽  
Fistula Formation ◽  
Secondary Patency ◽  
Dialysis Access ◽  
Hammersmith Hospital ◽  
History Of ◽  
Steal Syndrome ◽  
Brachiocephalic Fistula

Background: The arteriovenous fistula is the modality of choice for long-term haemodialysis access. We describe the feasibility of routinely fashioning a brachiocephalic fistula utilising a 3 mm long arteriotomy in an attempt to reduce the incidence of symptomatic steal syndrome yet while maintaining satisfactory clinical outcomes. Methods: All patients who underwent brachiocephalic fistula formation using a routine 3 mm long arteriotomy within Hammersmith Hospital between January 2017 and March 2018 were included. Primary outcomes included primary failure, failure of maturation, secondary patency and steal syndrome. Results: Sixty-eight brachiocephalic arteriovenous fistula were fashioned utilising a 3 mm long arteriotomy during the study period. Mean age was 60.5 years with 59% having a history of diabetes mellitus. Mean followup was 368 days. Primary failure occurred in 10 (14.7%) patients. Cannulation was achieved in 67.3% of remaining fistula within 3-months, rising to 87.3% by 6-months. Primary patency at 6 and 12 months was 76% and 69%, respectively. Secondary patency at 6 and 12 months was 94% and 91%, respectively. Dialysis access steal syndrome was clinically apparent in three (4.4%) patients with all cases being managed conservatively. Conclusion: A 3 mm long arteriotomy may be routinely utilised for brachiocephalic fistula creation in an attempt to limit the incidence of steal syndrome yet while maintaining clinical patency outcomes.

Outcomes of radiocephalic fistula created by nephrologists

2019 ◽  
Vol 20 (6) ◽  
pp. 615-620
Author(s):  
Narayan Prasad ◽  
Venkatesh Thammishetti ◽  
DS Bhadauria ◽  
Anupama Kaul ◽  
RK Sharma ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Care Center ◽  
Tertiary Care ◽  
Primary Patency ◽  
North India ◽  
Maintenance Hemodialysis ◽  
Secondary Patency ◽  
Arteriovenous Fistulas ◽  
Secondary Failure ◽  
Stage Renal Disease

Introduction: Arteriovenous fistula is considered as gold standard access for maintenance hemodialysis. Due to increasing burden of end-stage renal disease requiring dialysis, it is important for nephrologists to complement creation of arteriovenous fistula to meet the demand. Methods: This retrospective study was designed to assess the outcomes of arteriovenous fistula made by nephrologists at a tertiary care center from North India. The study included all radiocephalic arteriovenous fistula performed by nephrologists between November 2015 and January 2017. All arteriovenous fistulas were performed in patients whose duplex ultrasonography revealed both arterial and venous diameter of at least 2 mm. Data were collected with regard to age, gender, dialysis status, basic diseases, co-morbidities, and mineral bone disease parameters. The predictors of the primary and secondary patency rates were analyzed. Results: Five hundred patients (age 39.3 ± 14.4 years; 82.4% males; 21.6% diabetics) were included. In total, 83 (16.6%) patients had primary failure and 31 (7%) patients had secondary failure. Diabetes was associated with poor primary and secondary patency rates. Mean survival among the patients without primary failure was 11 months. The primary patency rates at 3, 6, 12, 18, and 21 months were 82%, 78%, 73%, 70%, and 70%, respectively. Conclusion: To conclude, the outcomes of radiocephalic arteriovenous fistulas created by nephrologists are at par with historic outcomes.

Thrombosed native hemodialysis fistulas: Technical and clinical outcomes of endovascular recanalization and factors influencing patency

2019 ◽  
Vol 20 (6) ◽  
pp. 725-732 ◽  
Author(s):  
Young Ho So ◽  
Young Ho Choi ◽  
Sohee Oh ◽  
In Mok Jung ◽  
Jung Kee Chung ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Proportional Hazards Model ◽  
Clinical Success ◽  
Clinical Results ◽  
Primary Patency ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Secondary Patency ◽  
Endovascular Recanalization ◽  
Factors Influencing

Purpose: To evaluate the technical and clinical results of endovascular recanalization of thrombosed native hemodialysis fistula and the factors influencing patency. Methods: A retrospective study was conducted with 73 patients who had thrombosed arteriovenous fistulas and were treated with endovascular methods. Patient characteristics, arteriovenous fistula-related characteristics, and endovascular procedures were analyzed. Technical and clinical results and patency rates were evaluated. The factors influencing patency were analyzed using a univariate and multivariate Cox proportional hazards model. Results: Technical and clinical success rates were 93% (68/73) and 85% (62/73), respectively. At 3, 6, and 12 months, the primary patency rates were 87.9%, 73.3%, and 64.8%; assisted primary patency rates were 89.2%, 78.6%, and 70.7%; and secondary patency rates were 90.8%, 87.2%, and 83.1%, respectively. Previous intervention and cephalic arch stenosis were risk factors for lower primary and assisted primary patency ( p < 0.05 for all). Cephalic arch stenosis was the only risk factor for lower secondary patency ( p < 0.05). No major complications associated with the procedures were noticed. Conclusion: Endovascular treatment was effective for the immediate recanalization of thrombosed arteriovenous fistula. In addition, previous intervention and cephalic arch stenosis were significantly related to lower arteriovenous fistula patency.

Strecker Stents in the Femoropopliteal Arteries: Value of Duplex Ultrasonography in Restenosis Assessment

1995 ◽  
Vol 2 (2) ◽  
pp. 150-160 ◽  
Author(s):  
Alan E. Bray ◽  
Wei G. Liu ◽  
Warren A. Lewis ◽  
Catherine Harrison ◽  
Ann Maullin
Keyword(s):  
Ultrasound Imaging ◽  
Ankle Brachial Index ◽  
Duplex Ultrasound ◽  
Primary Patency ◽  
Secondary Patency ◽  
Stent Deployment ◽  
Stent Patency ◽  
Site Specific ◽  
Stent Restenosis ◽  
A Prospective Study

Purpose: Experience with Strecker stent implantation in the femoropopliteal arteries has been described; however, few of the reports were prospective studies, and none routinely used site-specific assessment methods for follow-up evaluation of stent patency. The purpose of this study was to evaluate 1-year Strecker stent patency using duplex ultrasound imaging to obtain a more precise delineation of stent restenosis than is possible with other noninvasive assessment modalities. Methods: A prospective study involved 52 patients with 57 sites treated by angioplasty and Strecker stent deployment in the femoropopliteal arteries. Assessment included clinical evaluation; ankle-brachial index (ABI) measurements at rest and after exercise; and duplex ultrasound imaging preprocedurally and at 3 and 12 months after the intervention. Results: All 74 stents were deployed successfully in the 35 occluded arteries and 22 stenotic lesions. Acute reocclusion occurred in 6 (10%). At 3 months, primary patency was 81% and secondary patency 84%. Mean (± SD) ABIs increased from 0.64 ± 0.15 at rest and 0.32 ± 0.17 after exercise to 0.89 ± 0.14 and 0.68 ± 0.23, respectively (p < 0.0001). At 12 months, primary patency was 79%, and secondary patency was 82%. Mean ABIs were 0.82 ± 0.15 at rest and 0.52 ± 0.22 after exercise at 12 months (p < 0.0001 compared with preprocedural ABIs). Analysis of the length of lesion treated showed better results with shorter diseased segments, but this was not statistically significant (p > 0.05). Better outcomes were also obtained when one stent was used rather than two stents at 12 months (p = 0.15), but there was no difference at 3 months (p = 0.3). Thirty-four percent of the stented segments progressed from < 20% stenosis at 3 months to > 50% stenosis at 12 months. Overall, 19 (43%) of 44 segments progressed from < 50% stenosis at 3 months to a > 50% stenosis at 12 months. Restenosis seen at 3 months generally was in the native artery just proximal or distal to the stent, but at 12 months, restenosis was mainly inside the stent. Conclusions: Strecker stents at 1-year demonstrated satisfactory patency in the femoropopliteal arteries when deployed for angioplasty salvage or recurrent disease. The 3- and 12-month evaluations obtained with duplex ultrasound provided site-specific hemodynamic data for stent assessment. Resting ankle pressures were a poor index of restenosis.

Venovo venous stent in the treatment of non-thrombotic or post-thrombotic iliac vein lesions – short-term results from the Arnsberg venous registry

VASA ◽  
2019 ◽  
Vol 48 (2) ◽  
pp. 175-180 ◽  
Author(s):  
Michael K. W. Lichtenberg ◽  
Rick de Graaf ◽  
Wilhelm F. Stahlhoff ◽  
Ahmet Özkapi ◽  
Tienush Rassaf ◽  
...  
Keyword(s):  
Clinical Improvement ◽  
Symptom Relief ◽  
Duplex Ultrasound ◽  
Iliac Vein ◽  
Primary Patency ◽  
Clinical Severity ◽  
Secondary Patency ◽  
Stent Patency ◽  
Venous Clinical Severity Score ◽  
First Time

Abstract. Background: We sought to determine the patency and clinical symptom relief of the Venovo venous stent in the endovascular treatment of non-thrombotic (NIVL) or post-thrombotic venous obstruction (PTO) of the iliofemoral track over a period of 6 months. Patients and methods: A total of 80 patients (45 female, mean age 57 years) treated in 2016 and 2017 were included in the Arnsberg venous registry. Clinical improvement was determined by the revised venous clinical severity score (rVCSS) as well as the clinical, etiologic, anatomic and pathophysiologic (CEAP) score. Primary and secondary stent patency was evaluated using duplex ultrasound. Results: Overall 6-months patency rates were 98 % for primary and 100 % for secondary patency. For NIVL primary patency was 97 %, whereas for PTO primary patency was 96 %. Early stent re-occlusion occurred in 3 patients within 34, 59 and 156 days after intervention. Two of these patients were successfully treated by endovascular mechanical thrombectomy and stent in stent implantation. Clinical improvement with a gain of ≥ 2 rVCSS levels was observed in 51 %. CEAP scores decreased from 4.3 to 2.7. Conclusions: In this first time report the novel Venovo venous stent showed adequate patency rates associated with reasonable clinical improvement and low device-related complications throughout a 6-months-follow-up in both NIVL and PTO.

Balloon angioplasty: A promising adjunct to arteriovenous fistula creation compared with hydrostatic dilatation in small-caliber cephalic veins

2021 ◽  
pp. 021849232110415
Author(s):  
Santosh K Tiwari ◽  
Rajendra P Basavanthappa ◽  
Ranjith K Anandasu ◽  
Sanjay C Desai ◽  
Chandrasekhar A Ramswamy ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Balloon Angioplasty ◽  
Duplex Ultrasound ◽  
Primary Patency ◽  
Maturation Time ◽  
Arteriovenous Access ◽  
Dilatation Group ◽  
Stage Renal Disease ◽  
End Stage ◽  
Venous Segment

Background To maintain the patency and longevity of arteriovenous fistula, the availability of a venous segment with adequate diameter is important. In Indian population, many chronic kidney disease patients have poor caliber veins. The study aimed to evaluate the efficacy of hydrostatic dilatation versus Primary balloon angioplasty of small caliber cephalic veins of (≤2.5 mm) preoperatively in terms of patency rate and maturation time of arteriovenous fistula. Methods Patients ( n = 80) with an end-stage renal disease requiring arteriovenous access surgery for hemodialysis with small caliber cephalic veins were randomized into two groups, i.e., hydrostatic dilatation and primary balloon angioplasty, each with 40 patients. All patients underwent a thorough clinical examination as well as duplex ultrasound vein mapping of both upper extremities. Patients were followed up for six months and primary patency, maturation time, and complications were noted. Results Immediate technical success with good palpable thrill was achieved in 97.5% of patients in the primary balloon angioplasty group and 87.5% in the hydrostatic dilatation group. The fistula maturation time in the primary balloon angioplasty group was 34.41 days and 46.18 days in the hydrostatic dilatation group. In the primary balloon angioplasty group, the primary patency of the fistula was 97.5% and 87.5% in the hydrostatic dilatation group, at six months. The arteriovenous fistula functioning rate was 77.5% in the hydrostatic dilatation group as compared to 92.5% in the primary balloon angioplasty group at six months. The incidence of surgical site infection was 5% in the primary balloon angioplasty group as compared to 10% in the hydrostatic dilatation group. Conclusion Primary balloon angioplasty of small caliber cephalic veins (≤2.5 mm) performed prior to arteriovenous fistula creation for hemodialysis is a beneficial procedure.

Vein and artery diameter influence on arteriovenous fistula maturation and patency in a Mexican population

2021 ◽  
pp. 112972982110440
Author(s):  
Gustavo Martinez-Mier ◽  
Miguel Angel Cisneros-Tinoco ◽  
Francisco Gerardo Sanchez-Ruiz
Keyword(s):  
Arteriovenous Fistula ◽  
Duplex Ultrasound ◽  
Primary Patency ◽  
Mexican Population ◽  
Single Center ◽  
Vein Diameter ◽  
First Time ◽  
Fistula Maturation ◽  
Arteriovenous Fistula Maturation

Background: There is no consensus of the optimal arterial and venous sizes on arteriovenous fistula (AVF) function and patency. The purpose of our study was to determine the influence of vein and artery sizes on maturation and patency in autologous first time AVF in a vascular access clinic of Mexican Social Security. Methods: Approved IRB single-center retrospective study in patients referred for their first AVF from 01/2018/ to 04/2020. Perianastomotic inner vein diameter and single inner artery diameter was recorded by duplex ultrasound. Outcomes were: failure to mature (FTM) and cumulative primary patency survival. Results: Eighty-six AVF’s were created (mean age 45.5 ± 15.1 years; 62.8% male; mean BMI 25.9 ± 4.3 kg/m2). About 86% were brachiocephalic AVF. Eight (8.1%) AVF had FTM. Mean follow-up was 19.7 ± 8.5 months. Two-year patency survival was 81.4%. FTM vein and artery diameters (2.1 ± 0.3 and 2.8 ± 0.7 mm respectively) were smaller than successful AVF’s (3.1 ± 0.9 and 3.5 ± 0.6 mm) ( p < 0.05). ROC curve calculated a 2.15 mm vein diameter cutoff (AUC: 0.86) and a 2.95 mm artery diameter cutoff (AUC: 079) for FTM AVF’s (83% sensitivity, 72% specificity both) ( p < 0.05). AVF’s created with a vein diameter <2.15 mm and <2.95 mm artery diameter had statistically significant lower patency survival than AVF’s with larger vein and artery diameters ( p < 0.05). Conclusion: Vein diameter <2.15 mm and artery diameter <2.95 mm influences AVF maturation and patency in a Mexican population.

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