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Abstract: TH-PO327

Human Arteriovenous Fistula Wall Thickness in the First 6 Months After Creation

Session Information

  • Vascular Access - I
    November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 704 Dialysis: Vascular Access

Authors

  • Li, Yingnan, Baodi Clinical College of Tianjin Medical University, Tianjin, Tianjin, China
  • Tingey, Spencer B., University of Utah, Salt Lake City, Utah, United States
  • Cheung, Alfred K., University of Utah, Salt Lake City, Utah, United States
  • Shiu, Yan-Ting, University of Utah, Salt Lake City, Utah, United States
Background

Previous studies of the arteriovenous fistula (AVF) maturation process have focused almost exclusively on enlargement of the AVF lumen to allow increases in AVF blood flow. There is a lack of information regarding AVF wall thickness. Here we assess the change in AVF wall thickness, in conjunction with AVF lumen area, during the first 6 months after creation. We hypothesize that during AVF development, the wall thickens in response to lumen enlargement to maintain the structural strength and integrity of the wall.

Methods

Non-contrast black-blood magnetic resonance imaging (MRI) scans were performed on newly-created AVFs at 3 post-operative time points (1-3 days, 6 weeks and 6 months) in 10 ESRD patients at the University of Utah Hospital. MRI images were used to reconstruct 3D geometries of the AVF veins, from which the lumen area and wall thickness were calculated for the cross sections perpendicular to the lumen centerline at 1 mm intervals for 20 mm along the AVF length starting from the anastomosis.

Results

Fig. 1A-B shows the lumen area and wall thickness of each AVF at 3 sequential MRI scans. The lumen area increased from 14.26±5.40 mm2 at 1-3 days to 21.91±8.79 mm2 at 6 weeks to 30.62±12.78 mm2 at 6 months (p=0.0005 by ANOVA for 3 time points), while the wall thickness increased from 0.76±0.09 mm at 1-3 days to 1.05±0.23 mm at 6 weeks to 1.21±0.18 mm at 6 months (p<0.0001 by ANOVA for 3 time points). During this 6-month period, the lumen area change was positively associated with the wall thickness change (p=0.0369) (Fig. 1C).

Conclusion

In ESRD patients, AVF wall thickened as their AVF lumen area enlarged. More rigorous validation of this observation using a larger cohort is necessary.

Funding

  • NIDDK Support