Hemodynamic assessement of surgically created arteriovenous fistula for hemodialysis

ABSTRACT

Fifty patients with chronic renal failure were involved in this study. A radiocephalic fistula of the Brescia-Cimino type was newly created for hemodialysis in 45 patients. Nine of these 45 patients, showed an immediate fistula failure. Several hemodynamic parameters were found to be of important prognostic values to ensure a successful fistula outcome with a flow rate of >200 ml/min. A preoperative subclavien vein flow of >300 ml/min. and an arterial inflow of >/40 ml/min. were associated with a high fistula success rate. Besides, a postoperative decrease in resistively index [RI] of the inflow artery of >/0.1 resulted in a 100% success rate. Flow measurements were done by utilizing color flow duplex imaging. Therefore, the use of duplex imaging is beneficial during the evaluation of patients, who are candidates for an arteriovenous fistula operation. The remaining five patients had an already cerated arteriovenous fistula. They were studied with high output fistulas. This category of patients underwent banding correction of the existing fistulas. The banding technique resulted in reduction of fistula flow rates by a mean value of more than 60%