Korten E, Toonder I M, Schrama Y C, Hop W C J, van der Ham A C, Wittens C H A
Department of Non-Invasive Vascular Diagnostics, Vascular Centre, Saint Franciscus Hospital Rotterdam, Rotterdam, The Netherlands.
Eur J Vasc Endovasc Surg. 2007 Apr;33(4):467-71. doi: 10.1016/j.ejvs.2006.10.035. Epub 2006 Dec 29.
This study was designed to investigate the possibility of defining a vascular diameter with a practical cut-off point, which predicts a successful patency for radiocephalic arteriovenous fistulae in dialysis patients.
This is a retrospective analysis of prospectively gathered data. Consecutive patients (n=148) with chronic renal failure, needing vascular access for haemodialysis, were included if they underwent duplex ultrasound examination to evaluate preoperatively the vascular status and diameters for radiocephalic arteriovenous fistulae (RCAVF) construction. The associations between the diameter of the radial artery and cephalic vein and primary failure at six weeks, primary and secondary patency at one year were investigated.
There was no significant association between either radial artery diameter or dilated cephalic vein diameter and primary failure. There was an association between radial artery diameter and primary patency (Overall P=0.042). Males had a significantly larger mean radial artery diameter than females (P=0.005). Gender did not influence primary patency.
We recommend using radial artery diameters of > or = 2.1 mm and < or = 2.5 mm for RCAVF construction, this diameter category having the highest patency at 1 year. A single cut-off guideline cannot be recommended.
本研究旨在探讨确定一个具有实际临界值的血管直径的可能性，该临界值可预测透析患者头静脉桡动脉内瘘的通畅情况。
这是一项对前瞻性收集的数据进行的回顾性分析。纳入连续的慢性肾衰竭患者（n = 148），这些患者因需要血液透析的血管通路而接受了双功超声检查，以术前评估头静脉桡动脉内瘘（RCAVF）构建的血管状况和直径。研究了桡动脉和头静脉直径与六周时的初次失败、一年时的初次和二次通畅之间的关联。
桡动脉直径或扩张的头静脉直径与初次失败之间均无显著关联。桡动脉直径与初次通畅之间存在关联（总体P = 0.042）。男性的平均桡动脉直径显著大于女性（P = 0.005）。性别不影响初次通畅。
我们建议在构建RCAVF时使用直径≥2.1 mm且≤2.5 mm的桡动脉，这一直径范围在1年时具有最高的通畅率。不建议采用单一的临界值指南。
