Color Doppler ultrasonographic evaluation on the maturation of arteriovenous fistulas

Abstract

Objective　To prospectively determine whether the hemodynamic changes of radio-cephalic arteriovenous fistulas (RCF) peri-operative color Doppler ultrasonographic surveillance can predict the maturation.Methods　Twenty-two patients with end stage renal disease were enrolled in this study prospectively.The patients′ hemodynamic parameters of radial artery，brachial artery and cephalic vein which including A，PSA，EDV，RI，TAM and VF were measured with a portable duplex ultrasound unit before the operation and on the 2nd,4th,6th,8th,10th,12th,14th day post-operation.According to the result of clinical dialysis examination，patients were divided into two groups during 6 weeks postoperation：the mature group and the immature group.The means of medians of the post-operative hemodynamic parameters were calculated respectively.Results　In mature group，the preoperative and post-operative hemodynamic parameters of radial and brachial artery were regarded as statistically significant.VF，PSV and EDV were significantly higher after RCF.RI was significantly lower after RCF.In immature group，the preoperative and post-operative hemodynamic parameters of radial and brachial artery were regarded no significance.The ROC area of post-operative cephalic VF was 0.982 and the stand error was 0.026 with the asymptotic 95% confidence interval (0.931,1.034).The threshold of cephalic VF to predict RCF maturation was 263.25 ml/min.Conclusions　Color Doppler ultrasonographic examinations may predict RCF maturation and primary adequacy for dialysis during the first 2 weeks after the operation.