Haemodynamics Of Surgically Created Arteriovenous Fistula For Haemodialysis

Abstract

This study included 39 chronic renal failure patients who were referred to Vascular Surgery Department, Assiut University Hospital between May 2000 and July 2001. There were 22 males and 17 females with ages ranging from 24 to 69 years old (mean, 41.08 years). Thirty-six (Group I) patients were referred for creation of AVF. Other 3 (Group II) patients were already having AV fistulae, but complicated by venous hypertension. These 3 patients were included to study their haemodynamic values.

All the 36 created AV fistulae were performed by the side-to-side technique with radiocephalic anastomosis in 15 (41.67%) patients, brachiobasilic in 13 (36.11%) and, brachiocephalic in 8 (22.22%) patients.

Among the 15 patients with radiocephalic fistulae, 3 (20%) showed immediate failure while, only one (12.5%) brachiocephalic fistula failed. On the other hand, all the brachiobasilic fistulae were successful.

Several haemodynamic data of the axillary vein, as well as, the fistula inflow artery (the radial or brachial artery) were recorded in all patients before and one week after the operation. These included the cross­ sectional area, blood flow velocity, blood flow volume, and the RI (Resistivity index of the inflow artery) in each patient using color Duplex ultrasonography.

It has been noticed that in patients undergoing AVF operations, a preoperative axillary vein flow of> 300mllmin was associated with a high success rate (> 88%). On the other hand, patients with a pre-operative