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Updated: Jan 5, 2026
Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique
Published on: April 1, 2022
Determinants of successful arteriovenous fistulae creation including intraoperative transit time flow measurement
Alexander Meyer1,2, Eberhard Flicker2,3, Sascha T König1,2
1Department of General and Vascular Surgery, Johanniter Krankenhaus Rheinhausen, Duisburg, Germany.
Background:
The prevalence of hemodialysis patients is increasing, and it is important to create the arteriovenous fistula as early as possible to avoid hemodialysis by central venous catheter. International guidelines recommend arteriovenous fistula as the vascular access of first choice. Arteriovenous fistulae are associated with a failure rate of 23%. The success of an arteriovenous fistula can be evaluated intraoperatively by physical examination and by measuring the blood flow.
Objectives:
The aim of the study is to describe the predictive value of various factors for fistula maturation in the context to the current literature.
Methods:
We report on a prospective cohort study of 41 patients, undergoing a primary arteriovenous fistula at the upper extremity. The primary endpoint of the study was the successful fistula maturation after 6 weeks.
Results:
The intraoperative measurement of the blood flow in the outflow vein has been identified as the unique significant parameter for the fistula maturation.
Conclusion:
The predictive value of intraoperative flow measurement is superior to intraoperative physical examination and could help reduce the fistula dysmaturation rate. Intraoperative transit time flow measurement is an easy method and can be used to predict successful fistula maturation in a high percentage rate.
