A Clinical Significancy of Evoked Thrill Test in the Arteriovenous Fistula.
- Author:
Min Gue KIM
1
;
Jeong Hwan JANG
;
Seong Hwan KIM
;
Young Don MIN
;
Cheong Yong KIM
;
Kweon Cheon KIM
Author Information
1. Department of General Surgery, College of Medicine, University of Chosun, KwangJu, Korea.
- Publication Type:Original Article
- Keywords:
Early failure;
Atreriovenous fistula;
Evoked thrill test
- MeSH:
Arteriovenous Fistula*;
Consensus;
Fistula;
Humans;
Kidney Failure, Chronic;
Mass Screening;
Renal Dialysis;
Sensitivity and Specificity;
Thrombosis;
Veins;
Wrist
- From:Journal of the Korean Society for Vascular Surgery
2000;16(1):115-118
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Arteriovenous fistula at the wrist has remained the procedure of choice for long-term chronic hemod ialysis since its development by Brecia and Cimino in 1966. Thrombosis is the most common cause of early failure after arteriovenous fistula procedure, should be reconized preoperatively or intraoperatively, but no consensus exits regarding the ideal preoperative or intraoperative screening method for access surgery. We describe a simple intraoperative maneuver that can be used to detect proximal stenotic vein segments. METHODS: From September 1998 to September 1999, a total of 117 arteriovenous fistulas were performed for permanent hemodialysis in patients with chronic renal failure. Of them, a intraoperative evoked thrill test was performed in 61 patients (A group), in 56 patients (B group or control group) was not. RESULTS: Early failure rate (<30 days) was 12.5% in A group, 9.8% in B group or control group. In this study, the specificity and positive predictive value of the evoked thrill test was 100%, indicating that this maneuver is highly accurate in predicting early failure. CONCLUSION: Evoked thrill test is a simple and useful intraoperative method for improving the patency rate of autologous arteroiovenous fistula.
