Cephalic Vein and Radial Artery Diameter in Formation of Radiocephalic Arteriovenous Fistula: A Systematic Review

2015 ◽  
Vol 16 (6) ◽  
pp. 506-511 ◽  
Author(s):  
Ali Kordzadeh ◽  
Jameson Chung ◽  
Yiannis P. Panayiotopoulos
Keyword(s):  
Systematic Review ◽  
Arteriovenous Fistula ◽  
Radial Artery ◽  
Cephalic Vein

Venous distensibility is more important than venous diameter in primary survival of autogenous radiocephalic arteriovenous fistulas

2020 ◽  
Vol 21 (6) ◽  
pp. 963-968
Author(s):  
Guocun Hou ◽  
Yi Hou ◽  
Xiuli Sun ◽  
Na Yin ◽  
Guozhen Feng ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Confidence Interval ◽  
Arteriovenous Fistula ◽  
Radial Artery ◽  
Odds Ratio ◽  
Diabetic Kidney Disease ◽  
Peak Systolic Velocity ◽  
Cephalic Vein ◽  
Venous Distensibility ◽  
Vein Diameter

Background: Many studies suggested that the optimal cephalic vein diameter for wrist radio-cephalic arteriovenous fistula construction should be at least 2 mm to predict successful maturation and primary patency. However, our experience has shown that many patients with smaller cephalic vein diameter (≤2 mm) in the neutral state (without a tourniquet) also have good clinical outcomes. The aim of this study was to identify predictors that affect primary survival of new wrist radio-cephalic arteriovenous fistula in patients with cephalic vein diameter ≤2 mm. Methods: We performed a retrospective review of 50 patients with preoperative cephalic vein diameters ≤2 mm in the neutral state who underwent wrist radio-cephalic arteriovenous fistula construction between September 2016 and October 2019. Internal diameters of the cephalic vein and radial artery, venous distensibility, peak systolic velocity, and resistance index of the radial artery were determined by ultrasound examination before wrist radio-cephalic arteriovenous fistula placement. Patients were divided into two groups: failure and survival. Results: The radio-cephalic arteriovenous fistula survival rate was 68% from the time of radio-cephalic arteriovenous fistula creation until the end of the study. Univariate analysis showed that larger venous distensibility (p < 0.001), non-diabetic kidney disease (p = 0.009), and slower peak systolic velocity of the radial artery (p = 0.033) were predictive factors for primary radio-cephalic arteriovenous fistula survival. Multivariate regression analysis revealed good venous distensibility (odds ratio = 9.637, 95% confidence interval = 1.893–49.050, p = 0.006) and non-diabetic kidney disease (odds ratio = 0.148, 95% confidence interval = 0.033–0.660, p = 0.012) to be independent predictors for primary radio-cephalic arteriovenous fistula survival. Receiver operating characteristic analysis showed that venous distensibility >0.52 mm (sensitivity: 70.6%, specificity: 68.8%) was the best cut-off value to predict primary radio-cephalic arteriovenous fistula survival. Conclusion: When cephalic veins with diameter ≤2 mm are found, venous distensibility should be used to aid in the surgery decision-making process. The outcome of wrist radio-cephalic arteriovenous fistula survival would be significantly improved through the use of cephalic vein with venous distensibility >0.52 mm.

Effects of upper limb exercise programs on the arteriovenous fistula in patients on hemodialysis: A systematic review and meta-analysis

2021 ◽  
pp. 112972982110011
Author(s):  
Francini Porcher Andrade ◽  
Heloíse Benvenutti ◽  
Kacylen Costa da Silva ◽  
Paula Maria Eidt Rovedder
Keyword(s):  
Systematic Review ◽  
Arteriovenous Fistula ◽  
Flow Rate ◽  
Upper Limb ◽  
Handgrip Strength ◽  
Meta Analysis ◽  
Blood Flow Rate ◽  
Exercise Programs ◽  
Exercise Interventions ◽  
Limb Exercise

Background: The arteriovenous fistula (AVF) is a commonly used vascular access for chronic kidney disease (CKD) patients; exercise interventions may boost its maturation and help in its maintenance. A systematic review and meta-analysis of clinical trials on the effects of upper limb exercise programs on the AVF was conducted. Methods: The primary outcomes were draining vein diameter (DVD) and draining vein blood flow rate (DVBFR), and secondary outcomes were handgrip strength (HGS) and brachial artery flow rate (BAFR). Quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results: Four studies met the inclusion criteria. When compared to usual care groups, the experimental groups did not improve DVD (mean difference [MD] 0.23, confidence interval [CI] −0.20–0.65). There were significant differences in DVBFR (mL/min) according to the fixed-effect model (MD 141.13, CI 36.84–245.42). HGS (kg) was significantly different between groups (MD 2.95, CI 0.55–5.35), but BAFR (mL/min) was not (MD 91.65, CI −94.72–278.01). Conclusions: Although exercise programs did not improve DVD and BAFR, they increased muscle strength and DVBFR. Therefore, experimental exercise programs should be emphasized for AVF maturation and maintenance. Research Registry number: reviewregistry924.

Does blood flow restriction training increase the diameter of forearm vessels in chronic kidney disease patients? A randomized clinical trial

2018 ◽  
Vol 19 (6) ◽  
pp. 626-633 ◽  
Author(s):  
Jefferson BN Barbosa ◽  
Tuíra O Maia ◽  
Priscila S Alves ◽  
Shirley D Bezerra ◽  
Elaine CSC Moura ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Chronic Kidney Disease ◽  
Blood Flow ◽  
Kidney Disease ◽  
Radial Artery ◽  
Handgrip Strength ◽  
Cephalic Vein ◽  
Blood Flow Restriction ◽  
Control Group ◽  
Flow Restriction

Introduction: Blood flow restriction training can be used as an alternative to conventional exercise in chronic kidney disease patients with indication of arteriovenous fistula. Objective: Evaluating the efficacy of blood flow restriction training in the diameter and distensibility change of the cephalic vein and the diameter and flow of the radial artery, muscle strength and forearm circumference in chronic kidney disease patients with arteriovenous fistula pre-creation. Methods: A blind randomized clinical trial consisting of 26 chronic kidney disease patients allocated into a blood flow restriction training group (blood flow restriction; n = 12) and a group without blood flow restriction training (control group; n = 14). Blood flow restriction was performed at 50% of systolic blood pressure and using 40% of handgrip strength as load for the isometric exercises in both groups. Results: An increase in the diameter of the cephalic vein in the 2 cm (p = 0.008) and 10 cm segments (p = 0.001) was observed in the control group. The diameter of the radial artery increased in all segments in the blood flow restriction group (2, 10 and 20 cm; p = 0.005, p = 0.021 and p = 0.018, respectively) and in the 10 and 20 cm segments (p = 0.017 and p = 0.026) in the control group. Handgrip strength only increased in the control group (p = 0.003). Conclusion: Physical training associated with blood flow restriction increased cephalic vein diameters in both groups and was effective in increasing the diameter of the radial artery; however, it did not demonstrate superiority over the exercise group protocol without blood flow restriction.

scholarly journals Intra-arterial vasodilators to prevent radial artery spasm: a systematic review and pooled analysis of clinical studies

2015 ◽  
Vol 16 (8) ◽  
pp. 484-490 ◽  
Author(s):  
Chun Shing Kwok ◽  
Muhammad Rashid ◽  
Doug Fraser ◽  
James Nolan ◽  
Mamas Mamas
Keyword(s):  
Systematic Review ◽  
Radial Artery ◽  
Clinical Studies ◽  
Pooled Analysis

scholarly journals Acquired arteriovenous fistula formation following cephalic vein intravenous catheterisation in a cat

2019 ◽  
Vol 5 (1) ◽  
pp. 205511691983185
Author(s):  
Lisa Graziano ◽  
Stefania Di Paco ◽  
Giancarlo Avallone ◽  
Paola Roccabanca
Keyword(s):  
Arteriovenous Fistula ◽  
High Velocity ◽  
Clinical Findings ◽  
Cephalic Vein ◽  
Fistula Formation ◽  
Deep Dermis ◽  
Velocity Flow ◽  
History Of ◽  
First Time

Case summary A 10-year-old male neutered domestic shorthair cat was presented with a 4 month history of slow, progressive swelling and intermittent multifocal bleeding of the distal right forepaw that progressively developed after cephalic vein catheterisation for anaesthesia. The procedure was performed for dental calculus removal. Initial clinical and biopsy (superficial biopsy) findings matched two differential diagnoses: progressive angiomatosis and acquired peripheral arteriovenous fistula (AVF). AVF was suspected based on Doppler ultrasound examination that identified multiple abnormal sinusoidal neoformed branching vessels with turbulent high-velocity flow spectrum at the confluence of the artery and vein, and high-velocity arterialised flow in the vein. Owing to rapid and severe progression of lesions after biopsy, the owner requested amputation of the cat’s limb. A definitive diagnosis of acquired iatrogenic peripheral AVF was based on deep-tissue microscopical evaluation. High numbers of arterioles and venules in superficial and deep dermis embedded in oedematous stroma were connected to dilated and tortuous vessels with irregularly thickened walls in deep dermis and panniculus. Vasculitis and vascular thrombosis and thickening (attributed to local hypertension) were common findings. No bone or muscular invasion were observed. The cat was doing well 3 years after surgery. Relevance and novel information This report describes a case of iatrogenic acquired peripheral AVF following venous catheterisation in a cat, fully documented for the first time by a combination of clinical findings, ultrasound imaging, complete histopathology and follow-up history.

scholarly journals Distal radial artery ligation for treatment of steal syndrome associated with radiocephalic arteriovenous fistula

2020 ◽  
Vol 2020 (9) ◽  
Author(s):  
Mahmoud Tolba ◽  
Martin Maresch ◽  
Dhafer Kamal
Keyword(s):  
Arteriovenous Fistula ◽  
Radial Artery ◽  
Hemodialysis Patient ◽  
Ulnar Artery ◽  
Complete Relief ◽  
Retrograde Flow ◽  
Palmar Arch ◽  
Artery Ligation ◽  
Steal Syndrome ◽  
Distal Radial Artery

Abstract We present a case of dialysis associated steal syndrome in a hemodialysis patient with left radiocephalic arteriovenous fistula that caused him severe rest pain. Angiography showed retrograde flow from the ulnar artery to the distal radial artery through a hypertrophied palmar arch. The problem was solved by surgical ligation of the distal radial artery leading to complete relief of patient symptoms without any notable complications.

How to carry out monthly blood flow surveillance of fistula in large-scale hemodialysis units: A cross-sectional study

2020 ◽  
pp. 112972982092393
Author(s):  
Ya-wen Mo ◽  
Chun-yan Sun ◽  
Li Song ◽  
Li-fang Zhou ◽  
Ting-ting Zhuang ◽  
...  
Keyword(s):  
Blood Flow ◽  
Arteriovenous Fistula ◽  
Doppler Ultrasound ◽  
Radial Artery ◽  
Brachial Artery ◽  
Dilution Technique ◽  
Cross Sectional ◽  
Duplex Doppler Ultrasound ◽  
Duplex Doppler ◽  
Artery Flow

Background: The important effect of regular blood flow surveillance on arteriovenous fistula maintenance is emphasized. The ultrasonic dilution technique for blood flow surveillance can be performed during hemodialysis, but there are some limitations. Blood flow is traditionally measured by duplex Doppler ultrasound during the nondialysis period. However, the surveillance workload for arteriovenous fistula has increased with the rapid increase in the hemodialysis population size. Efficient methods for blood flow surveillance during hemodialysis are needed. Methods: Eighty-four hemodialysis patients with a forearm radiocephalic arteriovenous fistula were enrolled in this cross-sectional study. Each received blood flow measurements using ultrasonic dilution technique and duplex Doppler ultrasound during hemodialysis. Duplex Doppler ultrasound measurements included the blood flow of the brachial artery and radial artery. The correlations between these variables were analyzed. Results: The correlation coefficients ( r) between flow measured by ultrasonic dilution technique and brachial artery flow measured by duplex Doppler ultrasound, between flow measured by ultrasonic dilution technique and radial artery flow measured by duplex Doppler ultrasound, and between brachial artery flow and radial artery flow measured by duplex Doppler ultrasound were 0.724, 0.784, and 0.749, respectively (all p < 0.001). Conclusion: Blood flow measured by ultrasonic dilution technique was positively correlated with blood flow measured by duplex Doppler ultrasound during hemodialysis, suggesting that duplex Doppler ultrasound can be used to monitor the trends in the blood flow of the brachial artery and radial artery for timely intervention to improve patency during hemodialysis.

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