Vascular Factors Affecting Outcomes of Snuffbox AV Fistula with Side-to-Side Anastomosis: A Single Institutional Observational Study

Nephro-Urology Monthly

article

Ritesh R. Vernekar¹  Vikram Prabha²  Shashank D. Patil³ 

[1] Department of Nephrology, JN Medical College, KLE Academy of Higher Education and Research ,(Deemed-to-be-University);JN Medical College, KLE Academy of Higher Education and Research ,(Deemed-to-be-University);Department of Urology, JN Medical College, KLE Academy of Higher Education and Research ,(Deemed-to-be-University)

关键词: Arteriovenous Fistula;    Snuffbox;    Vascular;    Hemodialysis;   

DOI  :  10.5812/numonthly-123142

学科分类：基础医学

来源: Kowsar Corporation

【 摘 要 】

Background: Angioaccess is considered the "Tendon of Achilles" for hemodialysis. Arteriovenous fistula (AVF) is the commonlyentailed vascular access for hemodialysis.Objectives: The present study evaluates the outcomes of anatomical snuffbox AVF by preoperative and postoperative color Dopplerscans. It also determines the anatomical snuffbox AVF maturation rate concerning preoperative radial artery diameter (RAD),cephalic vein diameter (CVD), cephalic vein distensibility, and peak systolic velocity (PSV).Methods: This study was conducted from April 2020 to January 2021 on end-stage renal diseases (ESRD) patients undergoing anoperation for anatomical snuffbox AVF creation at our center after taking permission from the institutional ethics committee andwritten informed consent from patients.Results: Thirty-five ESRD patients underwent snuffbox arteriovenous fistula (SBAVF) creation, including 68% males and 32% females.Diabetes mellitus was noted in 40% and hypertension in 80%. Successful AVF maturation was noted in 92% (69.57% of males and30.43% of females). The mean RAD assessed on color Doppler ultrasonography (CDUS) preoperatively was 1.79 mm, while the peakvelocity of the radial artery at the snuffbox was 23.80 cm/s.Conclusions: We recommend applying the side-to-side configuration as its anastomosis angle is less owing to the lesser kink onthe anastomotic site. A longer segment of anastomosis is achieved, and better fluid dynamics and WSS profiles are seen in thisconfiguration with good outcomes.

【 授权许可】

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