Vein diameter after intraoperative dilatation with vessel probes as a predictor of success of hemodialysis arteriovenous fistulas

Fila, Branko and Lovčić, Vesna and Sonicki, Zdenko and Magaš, Saša and Sudar-Magaš, Zrinka and Malovrh, Marko (2014) Vein diameter after intraoperative dilatation with vessel probes as a predictor of success of hemodialysis arteriovenous fistulas. Medical Science Monitor, 20. pp. 191-198. ISSN 1643-3750

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BACKGROUND: Vascular access is "the life line" for patients on chronic hemodialysis. The autogenous arteriovenous fistula provides the best access to the circulation because of low complication rate, long-term use, and lower cost, compared to arteriovenous graft and central venous catheter. The primary objective of this prospective study was to investigate the predictive value of vein diameter after intraoperative dilatation with vessel probes on hemodialysis fistula maturation. ----- MATERIAL AND METHODS: Ninety-three fistulas were performed by a single surgeon from February 1, 2006 to January 31, 2009. Intraoperative vein dilatation with vessel probes was attempted in all fistulas. Measurements of the feeding artery diameter, vein diameter and the increased vein diameter after intraoperative dilatation were performed and immediate failure, early patency, early failure, primary patency, and fistula survival outcomes were recorded during 48-month follow-up. ----- RESULTS: Early failure occurred in 20% of fistulas and 70% matured sufficiently for cannulation. Variables with significant impact on the failure to mature by univariate analysis were: body-mass index (P=0.041), artery diameter (P<0.001), vein diameter (P=0.004), and vein diameter after dilatation (P=0.002). However, but multivariate analysis showed that only body-mass index (P=0.038), artery diameter (P=0.001), and the diameter of the vein after dilatation (P=0.018) significantly affected maturation. In a group of 56 (60%) patients with vein diameter before dilatation ≤ 2 mm, among vessel characteristics found by multivariate analysis, only vein diameter after dilatation (P=0.004) significantly affected function. ----- CONCLUSIONS: Artery diameter and vein diameter after intraoperative dilatation with vessel probes were the main predictors of fistula function.

Item Type: Article
Additional Information: This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
MeSH: Arteriovenous Fistula/surgery ; Blood Vessels/anatomy & histology ; Dilatation ; Endovascular Procedures/methods ; Humans ; Prospective Studies ; Renal Dialysis/methods ; Vascular Patency/physiology
Departments: Katedra za medicinsku statistiku, epidemiologiju i medicinsku informatiku
Depositing User: Marijan Šember
Status: Published
Sonicki, ZdenkoUNSPECIFIED
Sudar-Magaš, ZrinkaUNSPECIFIED
Date: 5 February 2014
Date Deposited: 01 Feb 2016 11:08
Last Modified: 16 Jul 2020 09:43
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