#4626 EFFECTS OF HEMODYNAMIC PARAMETERS OF THE BRACHIAL ARTERY ON AVF FLOW

Abstract Background and Aims Arteriovenous fistula (AVF) remains the preferred form of vascular access for hemodialysis, although dealing with the high rate of maturation failure. Many factors are found to be influencing the AVF outcome, however the diameter of the blood vessels, both arteries and veins, is recognized as the most important predictor. Aim of this study was to evaluate hemodynamic parameters of the brachial artery (Ab) on the change of volume flow (VF) during AVF maturation. Method This single-centre observational study included patients in whom AVF was created between September 2021 and December 2022. All patients underwent pre-operative physical and Color Doppler Ultrasound (CDU) measurements of the radial artery (Ar), brachial artery and cephalic vein (Vc). AVF maturation was evaluated by CDU consecutively 1, 14 and 28 days after AVF creation. As the hemodynamic parameters of the arteries, peak systolic volume (PSV), end-diastolic volume (EDV) and resistance index (RI) were measured. Results Study included 33 patients (81.8% male, mean age 64±10). VF was 346.55±126.86, 491.26±183.51, and 608.28±275.10 at day 1, 14 and 28, respectively (p = 0,000). Univariate regression analysis showed PSV (Beta = 0,456; p = 0,008) and EDV (Beta = 0,551; p = 0,001), both measured on Ab at day 1 post-AVF creation, are statistically significant predictors of flow change during 28 days of maturation. In the linear regression model EDV measured on Ab at day 1 post-AVF creation (Beta = 0,683; p = 0,003) and diameter of Ab (Beta = 0,441; p = 0,004) remained significant (Fig. 1 and 2). The vast majority of the study population undergone the first AVF puncture between 15-30th day post-creation (48.5%), while 12 (36.4%) and 5 (15.1%) experienced AVF puncture after more than 30 days and at the 14th day, respectively Conclusion Hemodynamic parametres of the brachial artery, precisely peak systolic volume and end-diastolic volume at the first day post-AVF creation, play a significant role in AVF maturation. CDU measurements of those hemodynamic parameters at day 1 may be useful for an early identification of AVF maturation outcomes.