AUTHOR=Feng Ruijia , Wang Siwen , Yu Jianwen , Zheng Xunhua , Chen Wei , Wang Xin , Chang Guangqi 

TITLE=The feasibility and efficiency for constructing arteriovenous fistula with <2 mm vein—a systematic review and meta-analysis

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1226136

DOI=10.3389/fcvm.2023.1226136

ISSN=2297-055X

ABSTRACT=<sec><title>Background</title><p>Autogenous arteriovenous fistula (AVF) is an efficient hemodialysis access for patients with end-stage kidney disease (ESKD). The specific threshold of vein diameter still not reached a consensus.</p></sec><sec><title>Method</title><p>We conducted a comprehensive search in PubMed, Embase, and Web of Science databases for articles which comparing the treatment outcomes of AVF with 2 mm as vein diameter threshold. Fixed and random effect model were used for synthesis of results. Subgroup analysis was designed to assess the risk of bias.</p></sec><sec><title>Result</title><p>Eight high-quality articles were included finally. Among a total of 1,075 patients (675 males and 400 females), 227 and 809 patients possessed &lt;2 mm and ≥2 mm vein respectively. Apart from gender and coronary artery disease (<italic>P</italic> &lt; 0.05), there was no significant difference in age, diabetes, hypertension or radial artery between maturation and non-maturation groups. The functional maturation rate was lower in patients with &lt;2 mm vein according to fixed effect model [OR = 0.19, 95% CI (0.12, 0.30), <italic>P</italic> &lt; 0.01]. There was no significant difference in primary [OR = 0.63, 95% CI (0.12, 3.25), <italic>P</italic> = 0.58] or cumulative patency rates [OR = 0.40, 95% CI (0.13, 1.19), <italic>P</italic> = 0.10].</p></sec><sec><title>Conclusion</title><p>Vein diameter less than 2 mm has a negative impact on the functional maturation rate of AVF, while it does not affect the primary and cumulative patency rates (12 months).</p></sec>