Role of color Doppler assessment in predicting outcomes of wrist Brescia-Cimino arteriovenous fistula creation: A single-center prospective study

Introduction: The most common reason for constructing an arteriovenous fistula (AVF) is chronic kidney disease. Various factors are associated with nonmaturation or failure of AVF, which can be evaluated using color Doppler/duplex ultrasound (DUS). We carried out this study to evaluate the role of p...

Full description

Bibliographic Details
Main Authors: Priyeshkumar Patel, Vikram Prabha, Ritesh R Verneker, Rajendra B Nerli, Taral Patel, Shridhar C Ghagane
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2023-01-01
Series:Indian Journal of Urology
Online Access:http://www.indianjurol.com/article.asp?issn=0970-1591;year=2023;volume=39;issue=1;spage=33;epage=38;aulast=Patel
_version_ 1797954978304753664
author Priyeshkumar Patel
Vikram Prabha
Ritesh R Verneker
Rajendra B Nerli
Taral Patel
Shridhar C Ghagane
author_facet Priyeshkumar Patel
Vikram Prabha
Ritesh R Verneker
Rajendra B Nerli
Taral Patel
Shridhar C Ghagane
author_sort Priyeshkumar Patel
collection DOAJ
description Introduction: The most common reason for constructing an arteriovenous fistula (AVF) is chronic kidney disease. Various factors are associated with nonmaturation or failure of AVF, which can be evaluated using color Doppler/duplex ultrasound (DUS). We carried out this study to evaluate the role of pre- and postoperative DUS for the prediction of outcomes of wrist radiocephalic (RC) AVF. Methods: In our prospective observational study, dialysis-dependent patients between 20 and 70 years of age undergoing primary RC-AVF from May 2019 to July 2020 were included. All patients underwent pre- and postoperative DUS examination after obtaining consent. Results: Among 104 participants, 87 (83.7%) were male and 17 (16.3%) were female. Successful maturation was seen in 68 (65.4%) participants, whereas 90 (86.53%) had functional maturation. Radial artery diameter (RAD) ≥1.6 mm, cephalic vein diameter (CVD) ≥2.0 mm, vein distensibility (VD) ≥0.5 mm, and peak systolic velocity (PSV) RAD ≥30 cm/s were associated with higher successful maturation of AVF with statistically significant results (P < 0.05). RAD ≥1.6 mm, CVD ≥2.0 mm, VD ≥0.5 mm, and PSV RAD ≥30 cm/s were related to a greater probability of RC-AVF maturation. Among them, VD and PSV-RA were the most influencing factors predicting RC-AVF successful maturation. Conclusions: If we consider the rule of six for AVF maturation, then the results will be much less than the actual fistulas which are dialyzable with adequate blood flow as per functional maturation criteria. Thus, more randomized studies are needed to define maturation criteria for the Indian population and to identify the effect of papaverine on successful AVF maturation.
first_indexed 2024-04-10T23:26:05Z
format Article
id doaj.art-2a309cbba4d84574aac93d8e58ab2d52
institution Directory Open Access Journal
issn 0970-1591
1998-3824
language English
last_indexed 2024-04-10T23:26:05Z
publishDate 2023-01-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Indian Journal of Urology
spelling doaj.art-2a309cbba4d84574aac93d8e58ab2d522023-01-12T12:11:39ZengWolters Kluwer Medknow PublicationsIndian Journal of Urology0970-15911998-38242023-01-01391333810.4103/iju.iju_190_22Role of color Doppler assessment in predicting outcomes of wrist Brescia-Cimino arteriovenous fistula creation: A single-center prospective studyPriyeshkumar PatelVikram PrabhaRitesh R VernekerRajendra B NerliTaral PatelShridhar C GhaganeIntroduction: The most common reason for constructing an arteriovenous fistula (AVF) is chronic kidney disease. Various factors are associated with nonmaturation or failure of AVF, which can be evaluated using color Doppler/duplex ultrasound (DUS). We carried out this study to evaluate the role of pre- and postoperative DUS for the prediction of outcomes of wrist radiocephalic (RC) AVF. Methods: In our prospective observational study, dialysis-dependent patients between 20 and 70 years of age undergoing primary RC-AVF from May 2019 to July 2020 were included. All patients underwent pre- and postoperative DUS examination after obtaining consent. Results: Among 104 participants, 87 (83.7%) were male and 17 (16.3%) were female. Successful maturation was seen in 68 (65.4%) participants, whereas 90 (86.53%) had functional maturation. Radial artery diameter (RAD) ≥1.6 mm, cephalic vein diameter (CVD) ≥2.0 mm, vein distensibility (VD) ≥0.5 mm, and peak systolic velocity (PSV) RAD ≥30 cm/s were associated with higher successful maturation of AVF with statistically significant results (P < 0.05). RAD ≥1.6 mm, CVD ≥2.0 mm, VD ≥0.5 mm, and PSV RAD ≥30 cm/s were related to a greater probability of RC-AVF maturation. Among them, VD and PSV-RA were the most influencing factors predicting RC-AVF successful maturation. Conclusions: If we consider the rule of six for AVF maturation, then the results will be much less than the actual fistulas which are dialyzable with adequate blood flow as per functional maturation criteria. Thus, more randomized studies are needed to define maturation criteria for the Indian population and to identify the effect of papaverine on successful AVF maturation.http://www.indianjurol.com/article.asp?issn=0970-1591;year=2023;volume=39;issue=1;spage=33;epage=38;aulast=Patel
spellingShingle Priyeshkumar Patel
Vikram Prabha
Ritesh R Verneker
Rajendra B Nerli
Taral Patel
Shridhar C Ghagane
Role of color Doppler assessment in predicting outcomes of wrist Brescia-Cimino arteriovenous fistula creation: A single-center prospective study
Indian Journal of Urology
title Role of color Doppler assessment in predicting outcomes of wrist Brescia-Cimino arteriovenous fistula creation: A single-center prospective study
title_full Role of color Doppler assessment in predicting outcomes of wrist Brescia-Cimino arteriovenous fistula creation: A single-center prospective study
title_fullStr Role of color Doppler assessment in predicting outcomes of wrist Brescia-Cimino arteriovenous fistula creation: A single-center prospective study
title_full_unstemmed Role of color Doppler assessment in predicting outcomes of wrist Brescia-Cimino arteriovenous fistula creation: A single-center prospective study
title_short Role of color Doppler assessment in predicting outcomes of wrist Brescia-Cimino arteriovenous fistula creation: A single-center prospective study
title_sort role of color doppler assessment in predicting outcomes of wrist brescia cimino arteriovenous fistula creation a single center prospective study
url http://www.indianjurol.com/article.asp?issn=0970-1591;year=2023;volume=39;issue=1;spage=33;epage=38;aulast=Patel
work_keys_str_mv AT priyeshkumarpatel roleofcolordopplerassessmentinpredictingoutcomesofwristbresciaciminoarteriovenousfistulacreationasinglecenterprospectivestudy
AT vikramprabha roleofcolordopplerassessmentinpredictingoutcomesofwristbresciaciminoarteriovenousfistulacreationasinglecenterprospectivestudy
AT riteshrverneker roleofcolordopplerassessmentinpredictingoutcomesofwristbresciaciminoarteriovenousfistulacreationasinglecenterprospectivestudy
AT rajendrabnerli roleofcolordopplerassessmentinpredictingoutcomesofwristbresciaciminoarteriovenousfistulacreationasinglecenterprospectivestudy
AT taralpatel roleofcolordopplerassessmentinpredictingoutcomesofwristbresciaciminoarteriovenousfistulacreationasinglecenterprospectivestudy
AT shridharcghagane roleofcolordopplerassessmentinpredictingoutcomesofwristbresciaciminoarteriovenousfistulacreationasinglecenterprospectivestudy