Hemodynamic assessement of surgically created arteriovenous fistula for hemodialysis

Abstract EN

Fifty patients with chronic renal failure were involved in this study.

A radiocephalic fistula of the Brescia-Cirnino type was newly created for hemodialysis in 45 patients.

Nine (20%) 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 > 200ml/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 resistivity 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 ofpatients who are candidates for an arteriovenous fistula operation.

The remaining 5 patients had an already cerated aeteriovenous 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 offistula flow rates by a mean value of more than 60%.