The association of lower peri-operative mean arterial pressure and primary failure in distal radio-cephalic arteriovenous fistula operations

Introduction: Arteriovenous fistula (AVF) is the recommended vascular access type for hemodialysis-dependent patients. Although the patency rates are respectable, primary failure is still a challenge. We aimed to investigate the association be-tween lower perioperative mean arterial pressure and primary failure in distal radiocephalic AVF operations. Methods: A total of 141 patients who underwent distal radiocephalic AVF operation were retrospectively investigated (70 females, mean age: 48.0±5.5). The patients were divided into two groups according to the average value of the perioperative mean arterial pressure measurements. Risk factors were compared between groups. Results: No difference was found between groups in terms of baseline characteristics and risk factors. The primary failure was found to be higher in the lower perioperative mean arterial pressure group (17% vs. 34%, p=0.030). Risk factors for primary failure were taken into univariate logistic regression analysis, and none were found significant. Discussion and Conclusion: Our study revealed that lower mean arterial pressure in the perioperative period is associated with a higher primary failure rate for distal radiocephalic AVFs.