Predictive value of one-week postoperative ultrasonography findings for the patency rate of arteriovenous fistula

Abstract Introduction Most guidelines in different countries recommend waiting more than 2 weeks for the initial cannulation of an arteriovenous fistula (AVF) after its creation. Although an experienced examiner can subjectively determine if an AVF is ready for early cannulation, there is a lack of objective information to guide whether early cannulation is appropriate or how early cannulation may affect an AVF’s primary patency. The present study examined the relationship between the initial cannulation and the prognosis of AVF, considering ultrasonography (US) findings. Methods This retrospective observational study enrolled 103 patients with end-stage renal disease who had started hemodialysis therapy from 2013 to 2015 at the Juntendo University Hospital. All patients had been given a primary AVF before or after the initiation of dialysis, had undergone US examinations both preoperatively and 7 days postoperatively, had initially cannulated their AVF at ≥7 days postoperatively and were followed up over 1 year. Results The factor associated with the loss of primary patency was resistance index (RI) of brachial artery ≥0.65 on US examination at 7 days postoperatively. There was no significant difference in patency rate between the early (within 14 days postoperatively) and the late initial cannulation groups (≥15 days postoperatively). Conclusion Because RI