Clinical significance of CT angiography in detecting hemodynamic parameters after autologous arteriovenous fistulaplasty in hemodialysis patients
JIA Xiufen1 LIU Jinjin1 ZHENG Chenfei2
1.Department of Radiology, the First Affiliated Hospital of Wenzhou Medical University, Zhejiang Province, Wenzhou 325000, China;
2.Department of Nephrology, the First Affiliated Hospital of Wenzhou Medical University, Zhejiang Province, Wenzhou 325000, China
Abstract：Objective To observe the hemodynamic parameters in the numerical model established under the CT angiography (CTA) detection data after autologous arteriovenous fistulaplasty (AVF) in hemodialysis patients. Methods From April 2019 to April 2020, 80 hemodialysis patients in the First Affiliated Hospital of Wenzhou Medical University were retrospectively analyzed. According to the patient’s hemodialysis results, they were divided into the dysfunction group (21 cases) and the control group (59 cases), and the hemodynamic parameters of two groups were compared and the predictive value of hemodynamic parameters for AVF dysfunction were analyzed. Results The blood flow velocity at the venous end of the anastomosis after AVF in the dysfunction group was lower than that of the control group, and the radial artery shear force was higher than that of the control group, and the differences were statistically significant (P < 0.05). Logistic regression analysis showed that slow blood flow velocity at the venous end of the anastomosis, high radial artery shear force were the influencing factors of AVF dysfunction (OR > 1, P < 0.05). Area under curve of blood flow velocity at the venous end of the anastomosis and radial artery shear force for AVF dysfunction prediction were 0.847 and 0.843 respectively, and the combined detection was 0.943. Conclusion The high incidence of AVF dysfunction after autologous AVF in hemodialysis patients may be related to slow blood flow velocity at the venous end of the anastomosis and high radial artery shear force. The blood flow velocity and radial artery shear force embodied in the numerical model established under the early CTA detection data can predict the risk of dysfunction after AVF and may have positive significance on guiding AVF effect evaluation and early intervention in hemodialysis patients.
2021, Vol. 18 
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