Predicting Suitable Diameters of Radial Artery and Cephalic Vein for Long Term Patency of Radiocephalic Arteriovenous Fistula

Abstract

Objective: To find out the cut-off values of vascular arterial and venous diameters effecting patency of arteriovenous
fistula (AVF) at wrist.
Methodology: In this longitudinal study with non-purposive consecutive sampling, all consecutive patients fulfilling
the inclusion criteria and undergoing radiocephalic AVF (RC-AVF) were included. Log-Rank test was applied to find the
cut-off points and Kaplan-Meier survival was used to detect vascular diameter effects on cumulative patency of RCAVF
at 2 years.
Results: A total of 150 RC-AVF were analyzed. Mean age at presentation was 53.5 (SD ± 4.76, Range 46-64) years.
Cardiac (P-value: 0.000) and peripheral vascular arterial disease (P-value: 0.004) had a strong negative association
with long term patency of access. Dichotomized cutoff point of radial artery was 2mm and cephalic vein was 2.5mm.
Radial artery diameter of less than 2mm (SE 1.155; CI: 5.66-525.2; P value: 0.001) and cephalic vein diameter of 2.5mm
(SE 1.155; CI: 5.66-525.2; P value: 0.001) are strongly associated with poor long-term patency of RC-AVF.
Conclusion: Cephalic vein of <2.5mm and radial artery of <2mm diameter is associated with statistically significant
failure rates of RC-AVF.
Keywords: Arteriovenous fistula; Fistula failure; Radiocephalic; Vascular diameter.