Efficacy of Using a Vessel Dilator during Surgery to Evaluate Vein Diameter and Predict Radiocephalic Arteriovenous Fistula Maturation and Patency

Background: We use vessel dilators to assess the diameter of the target vein during surgery for arteriovenous fistula (AVF) creation in hemodialysis patients. This study investigates the efficacy of using vein diameter as measured using dilators (surgical diameter; SD) versus that as measured by pre...

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Main Authors: Kanako Takai, Takehisa Nojima, Hidehiko Taguchi, Kosei Hasegawa, Takashi Yamauchi
Format: Article
Language:English
Published: MDPI AG 2024-10-01
Series:Surgeries
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Online Access:https://www.mdpi.com/2673-4095/5/4/76
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author Kanako Takai
Takehisa Nojima
Hidehiko Taguchi
Kosei Hasegawa
Takashi Yamauchi
author_facet Kanako Takai
Takehisa Nojima
Hidehiko Taguchi
Kosei Hasegawa
Takashi Yamauchi
author_sort Kanako Takai
collection DOAJ
description Background: We use vessel dilators to assess the diameter of the target vein during surgery for arteriovenous fistula (AVF) creation in hemodialysis patients. This study investigates the efficacy of using vein diameter as measured using dilators (surgical diameter; SD) versus that as measured by preoperative ultrasonography (ultrasonographic diameter; UD) to predict postoperative complications and patency. Methods: Sixty-three patients who underwent radiocephalic AVF creation and had measurements of UD and SD were retrospectively analyzed. Cutoff values for UD and SD regarding complications were used to dichotomize the patients into high and low groups for comparisons. Results: The 2-year primary and secondary patency rates overall were 66.5% and 88.9%, respectively. The optimal UD and SD cutoff values were 2.4 and 3.5 mm, respectively. The 2-year primary patency rate was higher in the high-SD group than the low-SD group (88.2% vs. 58.6%; <i>p</i> = 0.0426). The 2-year secondary patency rate was significantly higher in the high-UD/high-SD group than the low-UD/low-SD group (91.7% vs. 68.4%; <i>p</i> = 0.0067). Conclusions: Intraoperative measurement of vein diameter using dilators during AVF creation might be a useful method of predicting patency, particularly when SD is used in combination with UD.
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spelling doaj-art-2c865d64b7b0402eb7ea13b250dfda352025-08-20T02:51:10ZengMDPI AGSurgeries2673-40952024-10-015494895510.3390/surgeries5040076Efficacy of Using a Vessel Dilator during Surgery to Evaluate Vein Diameter and Predict Radiocephalic Arteriovenous Fistula Maturation and PatencyKanako Takai0Takehisa Nojima1Hidehiko Taguchi2Kosei Hasegawa3Takashi Yamauchi4Department of Cardiovascular Surgery, Higashiosaka City Medical Center, Osaka, Higashiosaka 578-8588, JapanNojima Vascular Access Clinic, Hyogo, Kobe 651-2273, JapanDepartment of Radiology, Higashiosaka City Medical Center, Osaka, Higashiosaka 578-8588, JapanDepartment of Cardiovascular Surgery, Sapporo Makomanai Hospital, Hokkaido, Sapporo 005-0013, JapanDepartment of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Suita 565-0871, JapanBackground: We use vessel dilators to assess the diameter of the target vein during surgery for arteriovenous fistula (AVF) creation in hemodialysis patients. This study investigates the efficacy of using vein diameter as measured using dilators (surgical diameter; SD) versus that as measured by preoperative ultrasonography (ultrasonographic diameter; UD) to predict postoperative complications and patency. Methods: Sixty-three patients who underwent radiocephalic AVF creation and had measurements of UD and SD were retrospectively analyzed. Cutoff values for UD and SD regarding complications were used to dichotomize the patients into high and low groups for comparisons. Results: The 2-year primary and secondary patency rates overall were 66.5% and 88.9%, respectively. The optimal UD and SD cutoff values were 2.4 and 3.5 mm, respectively. The 2-year primary patency rate was higher in the high-SD group than the low-SD group (88.2% vs. 58.6%; <i>p</i> = 0.0426). The 2-year secondary patency rate was significantly higher in the high-UD/high-SD group than the low-UD/low-SD group (91.7% vs. 68.4%; <i>p</i> = 0.0067). Conclusions: Intraoperative measurement of vein diameter using dilators during AVF creation might be a useful method of predicting patency, particularly when SD is used in combination with UD.https://www.mdpi.com/2673-4095/5/4/76arteriovenous fistula creationvein diametervessel dilatorpatencymaturation
spellingShingle Kanako Takai
Takehisa Nojima
Hidehiko Taguchi
Kosei Hasegawa
Takashi Yamauchi
Efficacy of Using a Vessel Dilator during Surgery to Evaluate Vein Diameter and Predict Radiocephalic Arteriovenous Fistula Maturation and Patency
Surgeries
arteriovenous fistula creation
vein diameter
vessel dilator
patency
maturation
title Efficacy of Using a Vessel Dilator during Surgery to Evaluate Vein Diameter and Predict Radiocephalic Arteriovenous Fistula Maturation and Patency
title_full Efficacy of Using a Vessel Dilator during Surgery to Evaluate Vein Diameter and Predict Radiocephalic Arteriovenous Fistula Maturation and Patency
title_fullStr Efficacy of Using a Vessel Dilator during Surgery to Evaluate Vein Diameter and Predict Radiocephalic Arteriovenous Fistula Maturation and Patency
title_full_unstemmed Efficacy of Using a Vessel Dilator during Surgery to Evaluate Vein Diameter and Predict Radiocephalic Arteriovenous Fistula Maturation and Patency
title_short Efficacy of Using a Vessel Dilator during Surgery to Evaluate Vein Diameter and Predict Radiocephalic Arteriovenous Fistula Maturation and Patency
title_sort efficacy of using a vessel dilator during surgery to evaluate vein diameter and predict radiocephalic arteriovenous fistula maturation and patency
topic arteriovenous fistula creation
vein diameter
vessel dilator
patency
maturation
url https://www.mdpi.com/2673-4095/5/4/76
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