Nephrology Dialysis Transplantation, Vol 13, Issue 12 3108-3110, Copyright © 1998 by Oxford University Press
S Sivanesan, T How and A Bakran
Background. The arteriovenous fistula is the most
widely used means of enabling vascular access for chronic haemodialysis.
When interest in vascular access was at its height, in the 1970s, a
substantial amount of work was carried out on the physiology of
arteriovenous fistulae and on the relationship between fistula flow and
patency. One omission in the catalogue of studies was research into the
distribution of flow in the fistula and the effects on surgical outcome.
Method. To address this issue, 30 patients with
end-to-side radiocephalic fistulae were studied. Flow measurements were
made intraoperatively, and at various intervals postoperatively using
colour-flow ultrasonography. Results. In 22 cases, the
development of the fistula was monitored at regular intervals for periods
of up to 27 months. In seven of the 30 fistulae, flow in the distal artery
was antegrade, while in the remaining 23, distal artery flow was
retrograde. The proportion of fistula flow supplied by the proximal and
distal arteries varied considerably. Conclusion.
Despite the wide range of flow distributions in the fistulae
studied, flow distribution did not appear to affect fistula maturation or
long-term function. Keywords: arteriovenous fistula;
blood flow; duplex ultrasound; flow distribution; haemodynamics
ORIGINAL ARTICLES
Characterizing flow distributions in AV fistulae for haemodialysis access
Department of Clinical Engineering, University of Liverpool, Liverpool, UK; Renal Transplant Unit, Royal Liverpool University Hospital, Prescott Street, Liverpool L7 8XP, UK; Corresponding author
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