Dialysis fistulae patency and preoperative diameter ultrasound measurements

Eur J Vasc Endovasc Surg. 2007 Apr;33(4):467-71. doi: 10.1016/j.ejvs.2006.10.035. Epub 2006 Dec 29.


Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arm / blood supply*
  • Arteriovenous Shunt, Surgical*
  • Brachiocephalic Veins / diagnostic imaging*
  • Brachiocephalic Veins / physiopathology
  • Brachiocephalic Veins / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Patient Selection
  • Practice Guidelines as Topic
  • Predictive Value of Tests
  • Preoperative Care
  • Proportional Hazards Models
  • Radial Artery / diagnostic imaging*
  • Radial Artery / physiopathology
  • Radial Artery / surgery
  • Renal Dialysis / methods*
  • Retrospective Studies
  • Risk Assessment
  • Time Factors
  • Treatment Outcome
  • Ultrasonography, Doppler, Duplex*
  • Vascular Patency*