MODIFIED METHOD OF ACCELERATING ARTERIOVENOUS FISTULA MATURATION USING VENOUS COMPRESSION TECHNIQUE
DOI:
https://doi.org/10.11603/2414-4533.2025.3.15625Keywords:
arteriovenous fistula (anastomosis), maturation of vascular access, exercises for acceleration the maturation of arteriovenous fistula, chronic kidney diseaseAbstract
The aim of the work: to investigate the clinical efficacy of a modified method of controlled venous compression in patients with terminal stage of chronic kidney disease, determination of its effect on the haemodynamics of arteriovenous fistulas, and comparison with standard methods of accelerating vascular access “maturation”.
Materials and Methods. A single-centred prospective study was conducted, which included observation of 128 patients with the 5th stage of chronic kidney disease whom primary radiocephalic arteriovenous fistulas (AVF) were formed on the upper limb in the lower third of the forearm. The examined were divided into three groups: group I, control (n=39) – patients who did not perform auxiliary exercises to accelerate the maturation of vascular access; group II experimental (n=43) – performed standard exercises with an expander for 5 minutes 3 times a day; group III experimental (n=46) – used a modified method of controlled venous compression (20 s of compression / 55 s of relaxation 2–3 times а day). The exercises were performed from the 10th day after the formation of vascular access.
Results. It was found that in patients of group II, increased blood flow velocity exceeded the control values after 1, 3 and 6 months by 10.19, 12.40 and by 11.95 % p<0.05), respectively, and the growth of the AVF diameter on the main vein was the greatest (20.83 %, p<0.05) 3 months after the vascular access formation. In group III, the highest growth of blood flow velocity (by 29.79 %, p<0.05) and diameter (by 37.21 %, p<0.05) compared to the control was registered one month after the beginning of the exercises, which characterises early fistula maturation. It is important that in patients of group III the lowest number of complications (26.08 %) was observed, while in group II and the control, this number was 30.20 % and 35.90 %, respectively.
Conclusions. The use of controlled venous compression is advisable in the postoperative stage of vascular access creation and can increase the functional effectiveness and duration of AVF use.
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