Evaluation value of upper extremity CT angiography in vascular evaluation of patients after arteriovenous fistula
Objective:To analyze the application value of upper extremity CT angiography(CTA)in the vascular aspects of patients after arteriovenous fistula.Methods:74 hemodialysis patients admitted to our hospital during mobile venous fistula surgery from January 2019 to December 2022 were selected as the study objects.All patients underwent CTA examination.The incidence of arteriovenous fistula dysfunction was analyzed.The CTA parameters of patients with different functional status of arteriovenous fistula were compared.The effects of CTA parameters on the function of arteriovenous fistula were analyzed.Value of CTA parameters in predicting arteriovenous fistula dysfunction in hemodialysis patients.The risk of arteriovenous fistula dysfunction in hemodialysis patients with different levels of CTA parameters was analyzed.Results:The dysfunctional rate of arteriovenous fistula was 25.68%(19/74).The shear force of the radial artery in the patients with poor function was higher than that in the patients with good function,and the blood flow velocity of the anastomotic vein was lower than that in the patients with good function(P<0.05).Shear force>35.22dyne/cm2 at radial artery and venous flow velocity≤109.42cm/s were the risk factors for poor function(P<0.05).The area under curve(AUC)of anastomotic venous flow velocity and radial shear force combined to predict arteriovenous fistula dysfunction was 0.830(P<0.05).The risk of arteriovenous fistula dysfunction in patients with high anastomotic venous flow velocity and radial shear force was 0.281 times and 3.049 times higher than that in patients with low anastomotic venous flow velocity(P<0.05).Conclusion:CTA can present the vascular status of arteriovenous fistula in hemodialysis patients.