European Journal of Cardiovascular Medicine

Background: There is no clear consensus on the artery and vein sizes affecting maturity of arteriovenous fistula (AVF). We sought to study the influence of artery and vein diameters on the maturation of first time native arteriovenous fistula in rural Indian population. Methods: Single-centre retrospective study of patients operated for their first AVF from Jan 2020 to Dec 2022. All patients underwent end-to-side anastomosis. Vein and artery diameters were measured intraoperatively. Patients who were successfully subjected to hemodialysis at the end of 4 – 6 weeks were deemed as matured. Results: A total of 105 patients, 75.24% (N = 79) males and 24.76% (N = 26) females. Mean age was 47.7 ± 13.9 years. BC-AVFs were created in 54 (51.42%) and RC-AVF in 51 (48.58%). Eighty-five (80.95%) AVFs matured and 20 (19.05%) failed. Maturity rate BC-AVFs 88.88%, RC-AVFs 72.54%. The differences in vein and artery diameters in the matured (1.92 ± 0.49 mm, 2.31 ± 0.69 mm respectively) and failed (1.70 ± 0.57 mm, 2.00 ± 0.46 mm respectively) groups were not statistically significant. (p = 0.08, p = 0.06). In BC-AVF group, cut-off size for maturity, of artery >2.6 mm (sensitivity-35.4 %, specificity-100 %, AUC - 0.65), of vein <2.2 mm (sensitivity-77.1%, specificity - 0%, AUC - 0.55), were not statistically significant (p = 0.09, p = 0.57 respectively). In RC-AVF group, cut-off size for maturity, of artery was >1.6 mm (sensitivity-75.7 %, specificity-50 %, AUC - 0.63), not statistically significant (p = 0.13), of vein was >1.5 mm (sensitivity-64.9%, specificity – 71.4%, AUC - 0.72), was statistically significant (p = 0.008). Conclusions: Vein (> 1.5 mm) and artery diameters do not influence maturation of AVF in rural Indian population.