Minimal diameter of the fistula vein defines a significant stenosis in an autologous arteriovenous fistula

Objective To define a parameter of autologous arteriovenous fistula stenosis that limits the fistula function for hemodialysis in our country. Methods Retrospectively study the doppler ultrasound of patients who accepted the percutaneous transluminal angioplasty (PTA) therapy due to autogenous arteriovenous fistula dysfunction; identify the least diameter of the fistula vein and compare it with the corresponding data of well-functioned fistula. Determine which absolute diameter constitutes a hemodynamically significant stenosis in a radiocephalic autologous arteriovenous fistula by receiver operating characteristic curve (ROC curve). Result Forty-two patients were enrolled in the study. The average age of those patients was 54.63±2.44 years old. Twenty-one patients were female. Twenty-six fistula located on the left arm. The minimal diameter of the dysfunction fistula averaged 1.57±0.07 mm, while the average forearm fistula vein diameter was 4.04±0.23 mm, significantly smaller than those in the compare group - an average minimal fistula vein diameter of 3.34±0.11 mm and a forearm vein diameter of 5.36(4.52, 6.45) mm (P<0.05). The control group contained sixty-eight patients. The average age of those patients was 52.56±2.00 years old. Thirty-one patients were female. Forty-nine fistula located on the left arm. It was quiet appropriate in using minimal diameter of the fistula vein to indicate the dysfunction istula with an under-curve area of 0.979, 95%CI 0.959-0.998. The under-curve area would be at the largest level when meeting the cutoff point at 2.40mm, in which it could achieve the area of 0.853. Conclusions The minimal diameter of the dysfunction wrist autogenous arteriovenous fistula was much smaller than the functioned ones. Minimal diameter of the fistula vein may serve as an effective parameter in detecting dysfunction fistula. Key words: Arteriovenous fistula; Constriction, pathologic; Cutoff