AI Article Synopsis
- The study evaluated the outcomes of radial-cephalic arteriovenous fistulas (RC-AVF) in patients before starting dialysis, focusing on their maturation and treating primary failures.
- A total of 127 RC-AVF procedures were analyzed, with specific criteria for maturity based on blood flow and vein diameter; the findings showed that a significant number of immature cases had lesions, mainly in the post-anastomotic vein.
- After six months, the study noted primary and secondary patency rates of 59% and 78%, respectively, emphasizing that effective monitoring through ultrasonography led to 80% of patients commencing dialysis with suitable distal AVF configurations.
Article Abstract
Unlabelled: The aim of the study was to analyse outcomes of AVF-RC in predialysis stage in which a clinical and radiological follow up of its maturation had been done and primary failure had been treated.
Material And Methods: We studied 127 RC-AVF in 117 predialysis patients. All cases had a preoperative map. The RC-AVF was considered mature if it had a brachial artery flow ≥500ml/min and a cephalic vein diameter of ≥4mm. Primary failure was treated radiologically or surgically depending on the type of lesion. Fifty-eight patients started dialysis at the time of the study.
Results: In 106 RC-AVF without thrombosis, 72 (68%) were mature and 34 (32%) were immature. A total of 97% of the immature had at least one lesion, and the most common site was the post-anastomotic vein. Lesions were found in 31% of mature RC-AVF, and 18% of patients required treatment. Radiological treatment was the most frequent for maturation failure. After 6 months, primary and secondary patency were 59% and 78%, while after 12 months they were 48% and 77%, respectively. The 80% of patients started dialysis with a distal AVF (76% RC-AVF and 4% ulnar basilic). None of the patients with treated immature RC-AVF started dialysis with CVC, while 78% of the patients started with said AVF.
Conclusion: Ultrasonography for monitoring maturation provides advantages over clinical monitoring. With our management of RC-AVF in predialysis, 80% of patients start dialysis with an adequate distal AVF.
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| http://dx.doi.org/10.1016/j.nefro.2015.10.016 | DOI Listing |
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