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  • Title: Hemodialysis access-induced ischemia is not related to configuration and access flow rates of upper arm arteriovenous fistulas at the elbow.
    Author: Peeters K, Heye S, Dewever L, Claes K, Fourneau I.
    Journal: Ann Vasc Surg; 2015; 29(4):682-9. PubMed ID: 25656688.
    Abstract:
    BACKGROUND: The purpose of the study was to find a relationship between the configuration of autogenous upper arm arteriovenous fistulas (AVFs) at the elbow and high access flow rates. METHODS: Forty-seven patients with well-functioning autogenous upper arm AVFs at the elbow were included. The configuration of the AVF and access flow rate was determined by duplex scanning. RESULTS: Hemodialysis access-induced distal ischemia scores and access flow rates were comparable in AVFs with 1 or 2 efferent veins (1829.9 ± 1121.3 mL/min, range [400-5000] vs. 1988.5 ± 1324.5 mL/min, range [130-5000]; P = 0.61). The basilic vein had statistically significant larger diameters than the cephalic vein (8.1 ± 2.7 mm, range [2.7-11.0] vs. 5.8 ± 2.5 mm, range [3.8-13.0]; P = 0.02), but no statistically significant difference in flow rates were observed (1884.5 ± 889.0 mL/min, range [824-3600] vs. 1130.0 ± 1258.4 mL/min, range [400-5000]; P = 0.53). Access flow rates were higher in AVFs with the brachial artery as afferent artery than when the radial artery was used (1909.5 ± 1273.2 mL/min, range [550-5000] vs. 1188.6 ± 642.7 mL/min, range [130-2800]; P = 0.02). CONCLUSIONS: There is no difference in access flow rates in autogenous AVFs at the elbow with 1 or 2 efferent veins. Autogenous AVFs at the elbow on the radial artery have lower access flow rates than AVFs on the brachial artery.
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