Prediction of wrist XXXX maturation with preoperative vein mapping with ultrasonography.

@entity1 @entity2548 @entity292
OBJECTIVE: The purpose of this study was to determine whether the preoperative minimal cephalic vein size in the forearm was predictive of successful wrist @entity292 maturation to a functional hemodialysis access. METHODS: Forty-four consecutive @entity1 underwent evaluation before surgery with ultrasound scan imaging to map the entire cephalic vein in preparation for the construction of an @entity2548 at the wrist. Measurements of the vein diameter were obtained from the ultrasound scan images at eight representative sites. @entity1 were clinically followed to determine maturation of the @entity292 to provide a functional hemodialysis access. The smallest diameter of the cephalic vein then was used as a preoperative predictor of @entity292 maturation. RESULTS: Successful maturation of the @entity2548 was achieved in 22 of the procedures (50%). Cephalic veins with a minimal diameter of 2.0 mm or less were used for anastamosis in 19 @entity1 (43%), and three of these procedures (16%) led to a functional access site. The remaining 25 @entity1 (57%) had minimal cephalic vein diameters greater than 2.0 mm, producing a successful maturation in 19 of the @entity292 creations (76%). A significantly higher rate of successful @entity292 maturation in those @entity1 with a preoperative minimal cephalic vein size greater than 2.0 mm was realized (P =.0002, chi(2) test, with Yates correction for continuity). CONCLUSION: In @entity1 with a minimal cephalic vein size of 2.0 mm or less, a procedure other than wrist @entity292 should be considered for optimization of dialysis access.
