Brachial-basilic AVF and prosthetic forearm loop access resulted in comparable changes in left ventricular structure at 3 months, with mean blood flows of 1450±221 and 1680±156 mL/min, respectively.
RCT (n=27)
Does a brachial-basilic AVF compared to a prosthetic forearm AVF differentially affect left ventricular hypertrophy in hemodialysis patients?
Creation of either a brachial-basilic or prosthetic forearm arteriovenous fistula results in comparable, limited short-term changes in left ventricular structure in hemodialysis patients.
BACKGROUND: Creation of an arteriovenous fistula (AVF) may increase left ventricular hypertrophy in the hemodialysis population. Aim of this study was to compare the effects of a brachial-basilic (BB) AVF and the prosthetic brachial-antecubital forearm loop access (PTFE) on cardiac performance. METHODS: Patients were randomized to receive BB-AVF or prosthetic brachial-antecubital forearm loop access. Before and three months after AVF creation patients underwent an echocardiographic examination. Mann-Whitney U-test was used to compare relative increase between the measured cardiac parameters for the two groups. RESULTS: Twenty-seven patients participated in the study. The relative increase in left ventricular parameters was not significantly different between the two groups. Only left ventricular end-diastolic diameter tended to be of significance. Mean blood flow through the brachial artery was 1680+/-156 and 1450+/-221 mL/min three months after surgery for the PTFE and the BB-AVF group, respectively. CONCLUSION: After three months of follow-up, changes in cardiac structure were comparable between patients with BB and PTFE AVFs. Also access flow was comparable at this time. In general, the effects of creation of a fistula on LV structure were limited. Longer follow up time may be needed to explore the long term effects of different vascular accesses on cardiac function.
Keuter et al. (Mon,) conducted a rct in Hemodialysis (n=27). Brachial-basilic (BB) arteriovenous fistula vs. Prosthetic brachial-antecubital forearm loop access (PTFE) was evaluated on Relative increase in left ventricular parameters. Brachial-basilic AVF and prosthetic forearm loop access resulted in comparable changes in left ventricular structure at 3 months, with mean blood flows of 1450±221 and 1680±156 mL/min, respectively.