Brachiocephalic arteriovenous fistula maturity in end stage renal disease: The role of intraoperative brachial artery blood flow rate and peak systolic velocity
Introduction: Arteriovenous fistula (AVF) is the preferred vascular access option due to its lower risk of complications and better long-term outcomes. However, AVF maturation failure is still quite high. Achieving an adequate blood flow rate (BFR) through the AVF is essential for maintaining hemodi...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2023-09-01
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| Series: | SAGE Open Medicine |
| Online Access: | https://doi.org/10.1177/20503121231196011 |
| _version_ | 1797683777322876928 |
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| author | Dedy Pratama Akhmadu Muradi Andre Saharui Aria Kekalih Muhammad Farel Ferian Bany Faris Amin |
| author_facet | Dedy Pratama Akhmadu Muradi Andre Saharui Aria Kekalih Muhammad Farel Ferian Bany Faris Amin |
| author_sort | Dedy Pratama |
| collection | DOAJ |
| description | Introduction: Arteriovenous fistula (AVF) is the preferred vascular access option due to its lower risk of complications and better long-term outcomes. However, AVF maturation failure is still quite high. Achieving an adequate blood flow rate (BFR) through the AVF is essential for maintaining hemodialysis adequacy. This study aims to investigate brachial artery intraoperative BFR and peak systolic velocity (PSV) increase as a predictor of brachiocephalic AVF maturation. Methods: A multicenter retrospective cohort study was conducted on patients with end stage renal disease undergoing brachiocephalic AVF creation from July 2019 to February 2022 from five hospitals. Doppler ultrasound examinations of BFR and PSV were collected. BFR and PSV increases were calculated by comparing pre-operative and intraoperative results. Maturity was determined at 6 weeks postoperatively. Results: This study included 83 patients, with 50 patients (60.24%) achieving maturity at 6 weeks. Brachial artery BFR difference has an excellent diagnostic value to predict brachiocephalic AVF maturation with an area under the curve (AUC) of 97%. BFR increase of 184.58 ml/min predicts brachiocephalic AVF maturity with a sensitivity of 100%, specificity of 84.8%, and accuracy of 93.98%. Meanwhile, brachial artery PSV increase has a low diagnostic value to predict brachiocephalic AVF with an AUC of 71.2%. PSV increase of 8.97 cm/s predicts brachiocephalic AVF maturity with a sensitivity of 82%, specificity of 51.5%, and accuracy of 69.9%. Conclusion: The increase in intraoperative brachial artery BFR and PSV in brachiocephalic AVF can be used as a useful parameter to predict AVF maturation. |
| first_indexed | 2024-03-12T00:20:45Z |
| format | Article |
| id | doaj.art-f4340428d92349599453d22fa483458f |
| institution | Directory Open Access Journal |
| issn | 2050-3121 |
| language | English |
| last_indexed | 2024-03-12T00:20:45Z |
| publishDate | 2023-09-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | SAGE Open Medicine |
| spelling | doaj.art-f4340428d92349599453d22fa483458f2023-09-15T14:03:37ZengSAGE PublishingSAGE Open Medicine2050-31212023-09-011110.1177/20503121231196011Brachiocephalic arteriovenous fistula maturity in end stage renal disease: The role of intraoperative brachial artery blood flow rate and peak systolic velocityDedy Pratama0Akhmadu Muradi1Andre Saharui2Aria Kekalih3Muhammad Farel Ferian4Bany Faris Amin5Division of Vascular and Endovascular Surgery, Department of Surgery, Faculty of Medicine, University of Indonesia - Cipto Mangunkusumo General Hospital, Central Jakarta, IndonesiaDivision of Vascular and Endovascular Surgery, Department of Surgery, Faculty of Medicine, University of Indonesia - Cipto Mangunkusumo General Hospital, Central Jakarta, IndonesiaDivision of Vascular and Endovascular Surgery, Department of Surgery, Faculty of Medicine, University of Indonesia - Cipto Mangunkusumo General Hospital, Central Jakarta, IndonesiaDepartment of Community Medicine, Faculty of Medicine, University of Indonesia, Central Jakarta, IndonesiaDivision of Vascular and Endovascular Surgery, Department of Surgery, Faculty of Medicine, University of Indonesia - Cipto Mangunkusumo General Hospital, Central Jakarta, IndonesiaDivision of Vascular and Endovascular Surgery, Department of Surgery, Faculty of Medicine, University of Indonesia - Cipto Mangunkusumo General Hospital, Central Jakarta, IndonesiaIntroduction: Arteriovenous fistula (AVF) is the preferred vascular access option due to its lower risk of complications and better long-term outcomes. However, AVF maturation failure is still quite high. Achieving an adequate blood flow rate (BFR) through the AVF is essential for maintaining hemodialysis adequacy. This study aims to investigate brachial artery intraoperative BFR and peak systolic velocity (PSV) increase as a predictor of brachiocephalic AVF maturation. Methods: A multicenter retrospective cohort study was conducted on patients with end stage renal disease undergoing brachiocephalic AVF creation from July 2019 to February 2022 from five hospitals. Doppler ultrasound examinations of BFR and PSV were collected. BFR and PSV increases were calculated by comparing pre-operative and intraoperative results. Maturity was determined at 6 weeks postoperatively. Results: This study included 83 patients, with 50 patients (60.24%) achieving maturity at 6 weeks. Brachial artery BFR difference has an excellent diagnostic value to predict brachiocephalic AVF maturation with an area under the curve (AUC) of 97%. BFR increase of 184.58 ml/min predicts brachiocephalic AVF maturity with a sensitivity of 100%, specificity of 84.8%, and accuracy of 93.98%. Meanwhile, brachial artery PSV increase has a low diagnostic value to predict brachiocephalic AVF with an AUC of 71.2%. PSV increase of 8.97 cm/s predicts brachiocephalic AVF maturity with a sensitivity of 82%, specificity of 51.5%, and accuracy of 69.9%. Conclusion: The increase in intraoperative brachial artery BFR and PSV in brachiocephalic AVF can be used as a useful parameter to predict AVF maturation.https://doi.org/10.1177/20503121231196011 |
| spellingShingle | Dedy Pratama Akhmadu Muradi Andre Saharui Aria Kekalih Muhammad Farel Ferian Bany Faris Amin Brachiocephalic arteriovenous fistula maturity in end stage renal disease: The role of intraoperative brachial artery blood flow rate and peak systolic velocity SAGE Open Medicine |
| title | Brachiocephalic arteriovenous fistula maturity in end stage renal disease: The role of intraoperative brachial artery blood flow rate and peak systolic velocity |
| title_full | Brachiocephalic arteriovenous fistula maturity in end stage renal disease: The role of intraoperative brachial artery blood flow rate and peak systolic velocity |
| title_fullStr | Brachiocephalic arteriovenous fistula maturity in end stage renal disease: The role of intraoperative brachial artery blood flow rate and peak systolic velocity |
| title_full_unstemmed | Brachiocephalic arteriovenous fistula maturity in end stage renal disease: The role of intraoperative brachial artery blood flow rate and peak systolic velocity |
| title_short | Brachiocephalic arteriovenous fistula maturity in end stage renal disease: The role of intraoperative brachial artery blood flow rate and peak systolic velocity |
| title_sort | brachiocephalic arteriovenous fistula maturity in end stage renal disease the role of intraoperative brachial artery blood flow rate and peak systolic velocity |
| url | https://doi.org/10.1177/20503121231196011 |
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