Application of color Doppler ultrasound in uremia patients with auto angiostomy
ObjectiveTo analyze influencing factors for the maturation of autogenous radial arterio-cephalic venous fistulas （AVF） in uremia patients by color Doppler ultrasound （CDU）， and to create a CDU-based system to assess the maturation of AVF.MethodsA total of 91 uremia patients treated in the Functional...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | zho |
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Editorial Department of Journal of Clinical Nephrology
2025-06-01
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| Series: | Linchuang shenzangbing zazhi |
| Subjects: | |
| Online Access: | http://www.lcszb.com/thesisDetails#10.3969/j.issn.1671-2390.2025.06.002 |
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| Summary: | ObjectiveTo analyze influencing factors for the maturation of autogenous radial arterio-cephalic venous fistulas （AVF） in uremia patients by color Doppler ultrasound （CDU）， and to create a CDU-based system to assess the maturation of AVF.MethodsA total of 91 uremia patients treated in the Functional Department of Shanghai Minhang District Hospital of Integrated Traditional Chinese and Western Medicine from June 15， 2023 to August 15， 2024 were selected as the research subjects. All patients underwent AVF surgery. According to the clinical or ultrasound maturity criteria， with 4 weeks after the operation as the dividing point， they were divided into the mature group and the immature group. The general clinical data， preoperative and postoperative （2 weeks， 4 weeks， 6 weeks） ultrasound examination indicators， and AVF-related complications of the two groups were compared.ResultsCephalic vein diameter （CVD） ［（2.08±0.17） mm <italic>vs</italic> （1.68±0.75） mm］ and radial artery diameter （RAD） ［（2.02±0.13） mm <italic>vs</italic> （1.61±0.11） mm］ in the mature group were significantly greater than those of the immature group （<italic>P</italic><0.01）.The radial artery intima-media thickness （RA-IMT） of patients in the mature group was significantly lower than that of the immature group ［（0.31±0.06） mm <italic>vs</italic> （0.44±0.78） mm， <italic>P</italic><0.01］. In addition， the detection rate of radial artery （RA） plaques in the mature group was significantly lower than that in the immature group， and the plaque size was significantly smaller ［（0.15±0.36） mm <italic>vs</italic> （0.88±0.33） mm， <italic>P</italic><0.01］. The inner diameters of at 2， 4， and 6 weeks after the operation （<italic>r</italic> =0.916， 0.812， and 0.956， respectively； all <italic>P</italic><0.01）， peak systolic velocity （PSV） （<italic>r=</italic>0.914， and 0.885， respectively； both <italic>P</italic><0.01）， and BF of the radial artery （RA）， cephalic vein （CV）， and brachial artery （BA） （<italic>r</italic>=0.956， 0.897， and 0.962， respectively； all <italic>P</italic><0.01） were positively correlated with the follow-up time， and the resistance index （RI） of RA and BA （<italic>r</italic>=-0.965， and-0.957， respectively， both <italic>P</italic><0.01） was negatively correlated with the follow-up time. Four weeks after the operation， the BF［（511.49±83.44） mL/min <italic>vs</italic> （979.88±234.14） mL/min <italic>vs</italic> （984.09±132.66） mL/min］， inner diameter ［（3.43±0.34） mm <italic>vs</italic> （5.34±0.14） mm <italic>vs</italic> （5.14±0.23） mm］， PSV ［（131.01±8.02） cm/s <italic>vs</italic> （133.12±8.24） cm/s］ and RI ［（0.38±0.02） <italic>vs （</italic>0.38±0.01）］ of the RA， CV， and BA in the mature group were significantly different from those in the immature group ［BF， （159.29±54.80） mL/min <italic>vs</italic> （239.00±184.26） mL/min <italic>vs</italic> （355.24±54.65） mL/min； inner diameter， （2.74±0.24） mm <italic>vs</italic> （3.62±0.41） mm <italic>vs</italic> （4.34±0.18） mm； PSV， （88.53±10.28） cm/s <italic>vs</italic> （99.06±10.56） cm/s； RI， （0.51±0.08） <italic>vs</italic> （0.52±0.16）； all <italic>P</italic><0.01］. The area under the curve （AUC） of CVBF in predicting AVF maturity at 4 weeks after the operation was 0.921. The cut-off for predicting AVF maturity was >486.5 mL/min， and the prediction effect was the best. Among 91 hemodialysis patients， 47 （51.6%） cases had internal fistula complications， among which 9 （9.89%） cases had thrombosis and 8 （8.79%） cases had vascular stenosis.ConclusionCDU has important clinical application value in AVF of dialysis patients. |
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| ISSN: | 1671-2390 |