Highlights
- •Diameter of veins used for AVF creation measured larger on intra versus preoperative mapping.
- •Assessing veins via intraoperative mapping leads to more distal AVF creation.
- •Utilizing intraoperative vein mapping does not compromise AVF maturation results.
Abstract
Background
We assessed the utility of intraoperative vein mapping performed by the operating
surgeon for evaluating vessel suitability for arteriovenous fistula (AVF) creation.
Methods
In a retrospective review of 222 AVFs, vein diameter measurements were compared between
intraoperative and preoperative mapping in the same anatomical location. AVF creation
was based on intraoperative vein diameter ≥2 mm, using a distal to proximal and superficial
veins first approach. Potential selection of access type based on preoperative findings
alone was analyzed.
Results
The mean diameter of the veins used for AVF creation measured 3.6 ± 0.8 mm on intraoperative
duplex versus 2.5 ± 0.9 mm when the same veins were measured on preoperative duplex.
Based on preoperative mapping alone, 23% of patients would have received a more proximal
AVF and 5% would have needed a graft. AVFs created more distally based on intraoperative
findings had similar maturation rates compared to the rest of the cohort, 79% versus
84% (p = 0.2).
Conclusions
Intraoperative vein mapping can be used to evaluate vessel suitability for AVF and
compared to pre-operative vein mapping may increase the eligibility of distal veins
for fistula creation while reducing the need for AV grafts.
Keywords
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Article info
Publication history
Published online: September 22, 2022
Accepted:
September 18,
2022
Received in revised form:
July 11,
2022
Received:
April 18,
2022
Identification
Copyright
© 2022 Published by Elsevier Inc.
