Display options
Cite
Bojakowski K, Gorczyca-Wiśniewska E, Szatkowski M, et al. Preoperative ultrasonographic examination of the radial artery and the cephalic vein and risks of dialysis arterio-venous fistula dysfunction. Pol J Radiol. 2010;75(1):7-12
Bojakowski, K., Gorczyca-Wiśniewska, E., Szatkowski, M., Walecki, J., & Andziak, P. (2010). Preoperative ultrasonographic examination of the radial artery and the cephalic vein and risks of dialysis arterio-venous fistula dysfunction. Polish journal of radiology, 75(1), 7-12.
Bojakowski, Krzysztof, et al. "Preoperative ultrasonographic examination of the radial artery and the cephalic vein and risks of dialysis arterio-venous fistula dysfunction." Polish journal of radiology vol. 75,1 (2010): 7-12.
Bojakowski K, Gorczyca-Wiśniewska E, Szatkowski M, Walecki J, Andziak P. Preoperative ultrasonographic examination of the radial artery and the cephalic vein and risks of dialysis arterio-venous fistula dysfunction. Pol J Radiol. 2010 Jan;75(1):7-12. PMID: 22802755; PMCID: PMC3389860.
Copy Download .nbib Format: NLM
Share it on

Pol J Radiol. 2010 Jan;75(1):7-12.

Preoperative ultrasonographic examination of the radial artery and the cephalic vein and risks of dialysis arterio-venous fistula dysfunction.

Polish journal of radiology

Krzysztof Bojakowski, Ewa Gorczyca-Wiśniewska, Maciej Szatkowski, Jerzy Walecki, Piotr Andziak

Affiliations

  1. Department of General, Vascular, and Oncological Surgery of the Medical University of Warsaw, Warsaw, Poland.

PMID: 22802755 PMCID: PMC3389860

Abstract

BACKGROUND: Hemodialysis used as renal replacement therapy requires a well-functioning vascular access. Arterio-venous fistula (AVF) created on the forearm is the best vascular access, but it also reveals numerous complications such as: lack of fistula maturation and hemodynamically significant stenoses. Many risk factors of fistula dysfunction are still not identified.

MATERIAL/METHODS: Radial artery and cephalic vein diameter and patency were ultrasonographically examined before forearm AVF creation. Intima-media complex width, blood flow and peak systolic velocity in distal part of radial artery were measured. Presence of thrombosis and post-inflammatory changes in cephalic vein were also checked. Forearm AVF was created in 66 patients. Fistula US examination was performed 3 and 12 months after operation with measurement of vessel diameter and blood flow. Fistula patency was observed in 24 months after creation. Comparison of pre- and postoperative US examinations between groups with well functioning and thrombosed fistulas was performed.

RESULTS: Primary patency of forearm AVF after 12 and 24 months was 65.2% and 53.0%, respectively. Patients with well functioning forearm AVF have significantly bigger cephalic vein diameter and peak systolic velocity in radial artery. We did not observe significant influence of radial artery intima-media complex width and radial artery diameter on AVF function. In postoperative examination, fistula diameter and flow significantly influenced the risk of AVF thrombosis.

CONCLUSIONS: US examination of radial artery and cephalic vein performed before forearm AVF creation enables identification of patients with greater risk of fistula dysfunction. Cephalic vein diameter and peak systolic velocity are prognostic factors of fistula function. Control postoperative US examination of forearm fistula enables detection of AVF at risk of thrombosis.

Keywords: arterio-venous fistula; risk factor; ultrasonographic examination

References

  1. Curr Opin Nephrol Hypertens. 2004 Nov;13(6):623-9 - PubMed
  2. Ann Thorac Cardiovasc Surg. 2006 Oct;12(5):341-8 - PubMed
  3. Kidney Int. 2007 Sep;72(6):665-6 - PubMed
  4. Am J Kidney Dis. 2002 Jun;39(6):1218-25 - PubMed
  5. Clin J Am Soc Nephrol. 2006 Mar;1(2):332-9 - PubMed
  6. Hypertension. 1997 Dec;30(6):1425-30 - PubMed
  7. Clin Nephrol. 2001 Sep;56(3):236-40 - PubMed
  8. Ann Vasc Surg. 2004 Mar;18(2):167-71 - PubMed
  9. Mt Sinai J Med. 2004 Mar;71(2):94-102 - PubMed
  10. Hypertension. 2004 Feb;43(2):163-8 - PubMed
  11. Blood Purif. 2009;27(2):212-9 - PubMed
  12. Am J Kidney Dis. 2001 Jan;37(1 Suppl 1):S137-81 - PubMed
  13. J Ultrasound Med. 2004 Feb;23(2):161-8; quiz 169-71 - PubMed
  14. Nephron Clin Pract. 2005;101(1):c45-6 - PubMed
  15. Eur J Radiol. 2005 Jul;55(1):113-9 - PubMed
  16. Hemodial Int. 2006 Apr;10(2):173-9 - PubMed
  17. J Vasc Surg. 2009 May;49(5):1325-36 - PubMed
  18. J Vasc Surg. 2008 Nov;48(5 Suppl):2S-25S - PubMed
  19. Am J Kidney Dis. 1993 May;21(5):457-71 - PubMed
  20. Nephrol Dial Transplant. 2006 Mar;21(3):715-20 - PubMed
  21. Acta Chir Scand. 1979;145(6):415-28 - PubMed
  22. Kidney Int. 2006 Oct;70(8):1413-22 - PubMed
  23. Lancet. 1999 Feb 27;353(9154):737-42 - PubMed

Publication Types