Effect of Chinese herbal fomentation on arteriovenous fistula maturation.

Objectives: The study objectives were to examine the effects of Chinese herbal fomentation on radiocephalic arteriovenous fistula (AVF) maturation.

Methods: All patients' preoperative evaluation, operative procedure, and follow-up information records were reviewed to identify patients undergoing radiocephalic AVF procedures for maintenance hemodialysis. All patients underwent preoperative vessel ultrasound. The ultrasound examinations were repeated every 2 months after the operative procedure. From the day after the operation, the forearm of the patient is fomented with a mixture of Dan Shen and Hong Hua in dry powdered form dissolved in fresh warm water. The fomentation lasted for 60 minutes, once a day for 28 consecutive days.

Results: Sixty-four (64) specific access site operations were yielded in 62 patients for analysis. Forty-nine (49; 76.6%) of the 64 fistulas were considered sonographically mature and 15 (23.4%) were deemed sonographically immature. The sonographically mature fistulas (n=46) that were suitable for puncture had blood flow of 655±132 mL/minute, and venous diameter of 4.5±0.3 mm. The most frequent complication was thrombosis before first use, which accounted for 6 AVFs failures to mature (0.16 per patient-year). There were two hospitalizations for fistula-related bacteremia in the group (0.05 per patient-year).

Conclusions: The Chinese herbal fomentation reduced the frequency of early thrombosis of new AVFs and was accompanied by an increase in the proportion of AVFs that were suitable for dialysis.