The arteriovenous fistula (AVF) is the first choice for gaining vascular access for hemodialysis. However, 20-50% of AVFs fail within 4 months after creation. Although demographic risk factors have been described, there is little evidence on the intraoperative predictors of AVF maturation failure. In this retrospective cohort study, the intraoperative blood flow, measured using TTFM, was compared to AVF maturation after 6 weeks in 55 patients. Due to its significantly higher prevalence and risk of non-maturation, the radiocephalic AVF (RCAVF) was the main focus of this study. A recommended cut-off point for high versus low intraoperative blood flow was determined for RCAVFs, using an ROC curve. The average intraoperative blood flow in RCAVFs was 156 mL/min. Patients with an intraoperative blood flow equal or lower than the determined cut-off point of 160 mL/min, showed a 3.03 times increased risk of AVF maturation failure after 6 weeks, compared to patients with a higher intraoperative blood flow (P < .001). The intraoperative blood flow in RCAVFs measured by TTFM provides an adequate means of predicting AVF non-maturation 6 weeks after surgery. For RCAVFs, a cut-off point for intraoperative blood flow of 160 mL/min is recommended for maximum sensitivity and specificity to predict AVF maturation failure after 6 weeks.

中文翻译：

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术中通过时间流量测量可预测桡头动静脉瘘的成熟

动静脉内瘘（AVF）是获得血液透析血管通路的首选。然而，20-50% 的 AVF 在创建后 4 个月内失败。尽管已经描述了人口统计学危险因素，但几乎没有证据表明 AVF 成熟失败的术中预测因素。在这项回顾性队列研究中，使用 TTFM 测量的术中血流量与 55 名患者 6 周后 AVF 的成熟情况进行了比较。由于放射头 AVF (RCAVF) 的患病率和未成熟风险明显较高，因此成为本研究的主要焦点。使用 ROC 曲线确定 RCAVF 术中高血流量与低血流量的推荐分界点。RCAVF 的平均术中血流量为 156 mL/min。与术中血流量较高的患者相比，术中血流量等于或低于确定的临界点 160 mL/min 的患者在 6 周后 AVF 成熟失败的风险增加了 3.03 倍 (P < .001 ）。通过 TTFM 测量的 RCAVF 术中血流量提供了预测术后 6 周 AVF 不成熟的充分方法。对于 RCAVF，建议术中血流量的截止点为 160 mL/min，以获得最大的敏感性和特异性，以预测 6 周后 AVF 成熟失败。