关键词: 改良方式, 血管保护, 前臂内瘘成形术, 安全性, 通畅率

Abstract: Objective To evaluate the safety and effectiveness of forearm arteriovenous fistula （AVF） created by radial artery deviation and reimplantation（RADAR）. Methods From June 2019 to October 2019, those patients accepted the forearm arteriovenous fistula created by RADAR were included, and their clinical and follow-up data were retrospectively collected and analyzed. Results A total of 5 patients were involved with a median age of 54 years. The preoperative ultrasound revealed that the median diameters of the radial artery and cephalic vein were 2.5 mm and 2.0 mm, respectively. The procedure was completed with a median operation time of 100 minutes （range： 80~140） and a median blood loss of 10 ml （range： 5~20）. Postoperatively, all 5 patients achieved technical success with a robust thrill, and no hand ischemia occurred. Two patients manifested with transient swollen hand. One patient with a history of heart failure experienced temporary chest tightness and shortness of breath, and recovered well after hemodialysis. At the one-month visit, 4 patients showed well-matured arteriovenous fistulas, while one patient had inadequate maturation and underwent balloon dilatation. During a median follow-up of 4 years （range： 1~6）, one patient died of septic shock at 5 years postoperatively, and another died of hepatocellular carcinoma at 4 years, both with patent fistulas prior to death. Among the 3 surviving patients, 2 maintained fistula patency, and one developed fistula failure at 1 year after surgery, requiring conversion to a prosthetic graft arteriovenous fistula. Conclusion RADAR to create AVF is safe with a high patency rate during the long-term follow-up period.

Key words: radial artery deviation and reimplantation, vessel protection, forearm arteriovenous fistula, safety, patency