Internal arteriovenous fistula, the essential procedure in obtaining vascular access for hemodialysis of patients with chronic renal failure, was developed by Brescia and Cimino in 1966.
In order to assess the influence of the fistula blood flow on the patency of the fistula, the author estimated the amount of the blood flow immediately and 15 minutes after creation of arteriovenous fistula using electromagnetic flowmeter and
followed
up these fistulas by dopplel Flow detector.
The fistula blood flow, immediately and 15 minutes after operation were, respectively, 130.55±39.62 ml/min and 174.05±30.71 ml/min in 22 cases of patent group whereas 77.25±38.55 ml/min and 78.88±38.79 ml min in 8 cases of early failure
group.
These
values were significantly different(p<0.05).
Six out of 12 patients whose fistula blood flow below 100 ml/min immediately after fistula creation were associated with early fistula failure due to thrombosis of fistula or inadequate blood flow for hemodialysis. And all six patients failed
whose
fistula blood flow below 100 ml/ min even at 15 minutes after fistula creation.
The group of increasing fistula flow rate after fistula creation showed 15.4% of early failure rate which was contrast to the 100% of early failure rate in the group of decreasing fistula flow rate.
Consequently, patients whose fistula blood flow were less than 100 ml/min(immediately after or 15 minutes after fistula creation) or whose fistula blood flow were not increased during these intervals, had a higher possibility of early fistula
failure.
Therefore, it may be necessary to make another fistula at other site in such cases without waiting for a long time or the fistula should be monitored carefully to maintain its function.
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