Abstract: Objective  To explore how to improve the maturation rate of the first arteriovenous fistula (AVF) through rational design of arteriovenous anastomosis.  Methods  The control group was treated with traditional end-to-side anastomosis of AVF, and the observation group used the formula prediction method to design the end-to-side anastomosis of AVF. The preoperative cephalic vein diameter and radial artery diameter, radial artery incision length, postoperative anastomotic diameter, postoperative cephalic vein outflow tract diameter, postoperative brachial artery blood flow, and AVF maturity rate were compared between the two groups.  Results  There were no significant differences in preoperative cephalic vein diameter (F=2.516, P=0.794) and postoperative radial artery diameter (F=0.381, P=0.861) between control group and observation group. The radial artery incision length was shorter in control group than in observation group (F=0.099, P＜0.001). In control group after the operation for 14, 28 and 42 days, the anastomotic diameter was smaller (F=3.812, 1.735 and 1.487 respectively; P＜0.001), the cephalic vein diameter was narrower (F=0.233, 1.442 and 0.002 respectively; P=0.012, 0.024 and ＜0.001 respectively), and the brachial artery blood flow was lower (F=2.287, 1.121 and 0.019 respectively; P＜0.001, =0.008 and =0.001 respectively), as compared with those in observation group. The fistula maturation rate was lower in control group than in observation group after operation for 28 and 42 days (c2=4.167 and 3.990, P=0.041 and 0.046).  Conclusions The design of fistula anastomosis using the formula prediction method is beneficial to improve the maturation rate of the first AVF.

Key words: Arteriovenous fistula; , End-to-side anastomosis, End-stage renal disease