Correlation between the Intraoperative Blood Flow and the early Patency of Radiocephalic Fistula

There have been many parameters that determined the results of radiocephalic ffisutla. However, few reliable intraoperative parameters have been suggested until now. The purpose of this study was to find the correlation between intra-operative blood flow and early patency of radiocephalic fistula.

Between March 1998 and October 1999, 45 radiocephalic arteriovenous fistulas were constructed in 38 patients. Intra-operative blood flow measurements were made 10 minutes after complection of the vascular anastomoses with 3-4mm handheld flow probes. Patients were followed until failure of fistula or 3months after first hemodialysis with these fistulas. Intraoperative blood flow as well as age, sex, presence of diabetes, size of cephalic vein, thrill on the fistula and flow of radial artery were correlated with early patency.

The mean intraoperative blood flow was 195.9±16.7 mL/min ranged from 50 to 500 mL/min, and it was the only significant parameter that determined early patency of radiocephalic fistula. Fistulas with flow less than 150 ml/min(10 of 18) revealed higher failure rate than those of flow more than 150 ml/min(1 of 27), which was statistically significant(p<0.01). All of the patients with flow less than 70 ml/min(5 of 5) failed in maintaining patency within a month. However, the other variables were not correlated with early patency.

In conclusion intra-operative blood flow measurements can be performed with ease and intraoperative blood flow in radiocephalic fistula is well correlated with early patency of the fistula. And we rocommend that radio-cephalic fistula of flow less than 150mL/min should be observed carefully and that of flow less than 70mL/min must be abandoned intraoperatively.