Objective To investigate the maturation and long-term patency of arteriovenous fistula(AVF)constructed by slender artery,and to analyze the influencing factors for maturation of the AVF based on the theory of vascular remodeling.Method Patients undergoing AVF operation using the radial artery diam-eter ≤1.5 mm for the construction were selected.The diameters of radial artery and cephalic vein were mea-sured by ultrasound before operation;Blood flow and diameters of cephalic vein and brachial artery were mea-sured after operation for one month.The maturation of AVF was evaluated and follow-up study was conduct-ed for 12 months to analyze the prognosis of AVF established by slender vessels.Result Fifty-six patients were included in this study.Before operation,the mean diameter of radial artery was 1.26±0.28mm,and the smallest diameter of radial artery was 0.5 mm;the average diameter of the cephalic vein after dilatation by tourniquet was 2.72±0.53 mm.AFV maturation progressed naturally without intervention in 40 patients(71.43％),and the AVF maturated after endovascular surgery or surgical reconstruction in 13(23.21％)of the remaining 16 patients.Regression model showed that radial artery diameter was an independent factor for pre-dicting AVF maturation,and the best critical value for predicting AVF maturation was radial artery diameter＞1.35 mm.The average follow-up time of the 56 patients was 11.39±5.81 months.After the operation for 3,6 and 12 months,the primary patency rates were 73.08％,68.75％and 65.71％respectively and the secondary patency rates were 100％,97.92％and 100％respectively.Conclusions AVF constructed by slender radial ar-tery has a high maturity rate and long-term patency rate.The radial artery diameter over 1.35mm is more like-ly to mature naturally.
Vascular accessArteriovenous fistulaSlender arteryVascular remodelingMaturation of arteriovenous fistula
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