Abstract:

Objective  To observe hemodynamic changes by color Doppler ultrasound technique after the construction of wrist arteriovenous fistula (AVF) and evaluate the maturity of AVF. Methods  The prospective study was carried out for patients with chronic renal failure who would undergo the construction of autologous wrist radiocephalic AVF. The internal diameters and blood flow of radial artery and cephalic vein, the intimal thickness of cephalic vein, and the depth of cephalic vein from the skin were measured by color Doppler ultrasound technique before and 1, 14, 28, and 56 d after surgery. The value change tendency was observed and maturity of AVF was assessed. Results  A total of 21 patients were enrolled from May 2014 to December 2014. Among them, 12 patients were male and 9 patients were female with ages of (54.3±13.2) years. Patients were followed up for 70 d and their autologous AVF all reached the clinical maturity criteria. Results of color Doppler ultrasound scan showed that internal diameters and blood flow of radial artery and cephalic vein 1 and 14 d after surgery increased most (P<0.01) and the increase slowed down afterwards. The differences of internal diameters and blood flow between 28 and 56 d after surgery were not statistically significant (P>0.05). The internal diameter and blood flow of cephalic vein 28 d after surgery were (5.0±1.0) mm and (1593.7±572.9) mL/min, respectively. The difference of the depth of cephalic vein from the skin after surgery was not statistically significant (P>0.05). Conclusion  The maturity of AVF is based on the perfect evaluation of radial artery and cephalic vein before surgery. The results of ultrasound scan have shown that the internal diameter and blood flow of cephalic vein 1 month after surgery can meet the requirements of hemodialysis. So for cephalic vein, the internal diameter >4 mm and blood flow >500 mL/min can be regarded as the maturity criteria of AVF for Chinese people. However, determination of the final criteria still needs prospective study based on large samples.

Key words: arteriovenous fistula, maturity, Doppler ultrasound