Hemodialysis arteriovenous fistula peri and postoperative vascular assessment

Abstract

Introduction: Culminate treatment of chronic renal failure is hemodialysis. And hemodialysis is most convin end treatment for chronic renal failure. If can made by central venous catheter and arteriovenous fistula. But arteriovenous fistula hemodialysis treatment is more accurate treatment for high risk patients it can rediuce the complication. Arteriovenous fistula hemodialysis can prolong central venous catheter usage. And it has few other benifits. Such as reduce the complication, prolong the artherial usage and venous. Its important to determine the shape, diametr of the venois vessel. It will help the surgeon to evaluate the surgical reach, and prevent severe bleeding, reduce complication and mortality. Objective: Examination of the superficial venous variant and diameter of the cubital fossa using vascular Doppler ultrasound. Materials and Methods: We surveyed 84 people, aged 19-79, who applied to the dialysis treatment for the diagnosis of chronic renal failure, with the appropriate ethical permission at the First Central Hospital of Mongolia, Department of General Surgery. Patients who’s about to have an arteriovenous fistula surgery should give a clinical examination (such as DUS examination). In this study used the internationally accepted Kaissar Yammine classification to determine the superficial veins of the cubital fossa variant and vascular diameter. And cephalica vein and basilica vein diameter should be evaluated before 1-120 days of surgery. Conclusion: M (Y) and H variants of v.cephalica are more common in Mongolians. Variants of basilic vein joins with the brachial venous system to form the axillary vein are more common in Mongolians. H and I (O) variants are more common in females, M or Y variants in males, and more specific variants with additional threads in the right hand. In preoperative vascular measurements, the diameter of the arteries did’t difference between a.radialis and a.ulnaris, and the mean diameter was 0.2 cm higher. In the postoperative measurement, on the first day after surgery, the diameter of the collecting vessel doubled. On the 10th postoperative day, the diameter of the collecting vessel was more than 0.6 cm. On the 30th day, the diameter decreases, but the shunt maturation is insufÏcient. From the 60th and 120th days after surgery, the diameter of the collecting vessel stabilizes.