Outcomes of arteriovenous fistula creation, effect of preoperative vein mapping and predictors of fistula success in incident haemodialysis patients: A single‐centre experience
The preoperative evaluation is an imperative part of vascular access planning. Assessment of anatomical suitability for AVF creation by clinical examination alone can be difficult in certain groups of patients, and there has been on‐going interest at whether the use of ultrasonographic vein mapping preoperatively can improve AVF outcomes. The existing Kidney Disease Outcomes Quality Initiative (KDOQI) guideline recommends routine use of preoperative vein mapping in all patients before access placement, with vein diameter threshold of 2.0 to 2.5 mm for higher AVF success rate.1 However, robust evidence supporting this recommendation is lacking. Some authors suggested selective use of vein mapping, as routine imaging offers no advantage over physical examination with favourable anatomical suitability, and unnecessary investigation may cause delay and additional cost.10
Preoperative vein mapping is not routinely performed in our centre for incident haemodialysis patients with suitable veins on physical examination. AVF maturation rate, in relation to preoperative vein mapping and vein diameter in our institution has not been previously reported. We sought to evaluate the outcomes of AVF creation, effect of preoperative vein mapping and predictors of fistula success in our incident haemodialysis patients.