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A Novel Murine Model of Arteriovenous Fistula Failure: The Surgical Procedure in Detail
Published on: February 3, 2016
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Prognostic Factors for Arteriovenous Fistula Maturation
Carney Chan1, Christian J Ochoa2, Steven G Katz2
1Department of Surgery, Huntington Memorial Hospital, Pasadena, CA.
Annals of Vascular Surgery
|February 26, 2018
Summary
Arteriovenous (AV) fistula maturation was successful in 72% of patients, with higher BMI negatively impacting outcomes. Age, fistula location, and vein size were not significant predictors for AV fistula success.
Area of Science:
- Vascular Surgery
- Nephrology
- Dialysis Access
Background:
- Arteriovenous (AV) fistula maturation rates vary (40-80%).
- Older age, distal location, and small vein diameter are linked to AV fistula failure.
- This study validates institutional outcomes against existing literature.
Purpose of the Study:
- To determine if reported AV fistula maturation failure predictors are consistent at our institution.
- To analyze factors influencing AV fistula maturation success.
Main Methods:
- Retrospective chart review of upper extremity AV fistula creation.
- Analysis of patient demographics, risk factors, fistula location, and vein diameter (preoperative ultrasound).
- Statistical analysis using Pearson Chi-Square, Fisher's Exact Test, and Mann-Whitney U-tests.
Main Results:
- Overall successful AV fistula maturation rate was 72% (105/146 fistulas).
- Higher BMI (>29.5) was the only significant negative predictor (P=0.026).
- Age, fistula location, and vein size did not significantly impact maturation rates.
Conclusions:
- A 72% AV fistula maturation rate was achieved using veins ≥2.5 mm.
- BMI >29.5 is a significant negative predictor for AV fistula maturation.
- Age, sex, and fistula location should not exclude patients with adequate vein diameter from AV fistula creation.
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