The Effect of Artery and Vein Size on Forearm Hemodialysis Arteriovenous Graft Patency

Ann Vasc Dis. 2019 Mar 25;12(1):21-24. doi: 10.3400/avd.oa.18-00105.

Abstract

Objective: Arteriovenous grafts (AVGs) are considered to be an alternative procedure when autogenous fistulas are not feasible. This study was conducted to establish a correlation between the inflow artery and outflow vein size and patency of AVGs. Materials and Methods: This was a retrospective descriptive study. Data was collected from patients who had forearm AVG performed at a university hospital from January 1, 2012, to December 31, 2016. Spearman's rho correlation test was used to identify the correlation between the artery and vein size and patency of AVG. Results: A total of 34 patients were enrolled in this study. Forearm loop configuration was performed in 33 patients (97%), and straight configuration was performed in one patient (3%). The median size of the brachial artery was 3 mm (interquartile range [IQR]: 2, 4) and that of the vein was 3 mm (IQR: 2, 5). The overall primary patency was 74% at six months, 59% at one year, and 32% at two years. The analysis showed that the primary patency increased with the artery size, but there was a reverse correlation between vein sizes. Conclusion: Small inflow arteries may reduce the primary patency, but small veins do not result in a poor primary patency. Our method can be applied to patients with small veins, where it is still possible to perform forearm AVGs.

Keywords: arteriovenous graft; hemodialysis.