Atanga Harvey Onana, Seme Ambroise, Mahamat Maimouna, Onana Yannick, Guegang Emilienne
Radiology Unit, Ngaoundere Regional Hospital, Ngaoundere, Cameroon.
Radiology and Radiation Oncology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
J Ultrason. 2024 Nov 30;24(98):1-5. doi: 10.15557/jou.2024.0028. eCollection 2024 Dec.
Arteriovenous fistulas are created to serve as a vascular access in hemodialysis patients. Our study assessed the Doppler ultrasound characteristics of upper limb arteriovenous fistulas.
We carried out a cross-sectional, consecutive sampling study at the Yaoundé University Teaching Hospital. We interviewed consenting patients on maintenance dialysis performed for at least one month via an upper limb arteriovenous fistula, which was subsequently scanned. We compared the proportions and means using chi-squared and ANOVA tests, respectively, with a threshold for significance set at a value ≥0.05.
Between 1 July and 31 August 2022, we recruited a total of 41 participants, of whom 56.1% were males. The mean age of the participants was 48.39 years. Radiocephalic (76%) and brachiocephalic (24%) arteriovenous fistulas were the only types present. The mean flow volume in the arteriovenous fistulas was 680.47 (365.98) ml/min, with 34.1% of the fistulas having a low flow volume. Also, 56.1% of the arteriovenous fistulas were stenosed, with the main site of stenosis being the juxta-anastomotic segment of the efferent vein. Aneurysms (53.7%), reverse flow (51.2%), venous luminal flaps (22%), and thrombus (17.1%) were the most common complications identified in the study population, with 78.05% of the arteriovenous fistulas having at least one complication. Factors associated with arteriovenous fistula stenosis included the patient body mass index and the radiocephalic fistula type. Diabetes, aneurysms, and luminal venous flaps were found to be associated with low flow volume.
The prevalence of vascular modifications and stenosis within functional arteriovenous fistulas was high.
动静脉内瘘用于为血液透析患者提供血管通路。本研究评估上肢动静脉内瘘的多普勒超声特征。
我们在雅温得大学教学医院进行了一项横断面连续抽样研究。我们对通过上肢动静脉内瘘进行维持性透析至少1个月的同意参与研究的患者进行了访谈，随后对其进行扫描。我们分别使用卡方检验和方差分析比较比例和均值，显著性阈值设定为P值≥0.05。
在2022年7月1日至8月31日期间，我们共招募了41名参与者，其中56.1%为男性。参与者的平均年龄为48.39岁。仅存在桡动脉头静脉（76%）和肱动脉头静脉（24%）动静脉内瘘两种类型。动静脉内瘘的平均血流量为680.47（365.98）ml/分钟，34.1%的内瘘血流量较低。此外，56.1%的动静脉内瘘存在狭窄，狭窄的主要部位是流出静脉的吻合口近端节段。动脉瘤（53.7%）、逆流（51.2%）、静脉腔内瓣（22%）和血栓（17.1%）是研究人群中最常见的并发症，78.05%的动静脉内瘘至少有一种并发症。与动静脉内瘘狭窄相关的因素包括患者体重指数和桡动脉头静脉内瘘类型。发现糖尿病、动脉瘤和静脉腔内瓣与低血流量相关。
功能性动静脉内瘘中血管改变和狭窄的患病率较高。
