Abstract: Objective  To observe the effect of functional end-to-side anastomosis with radial artery superficial displacement (FETSRAS) on the maturation of radiocephalic arteriovenous fistula (RC-AVF) in the distal forearm.  Method  Patients undergoing the first RC-AVF creation in distal forearm at the Department of Blood Purification, the People’s Hospital of Rizhao from March 2020 to June 2022 were selected as the study subjects. They were divided into the conventional end-to-side anastomosis (CETS) group and FETSRAS group, according to the method of RC-AVF creation. During the 12 weeks of postoperative follow-up, clinical vascular examination and fistula’s pump controlled blood flow were used to evaluate the clinical fistula maturation status, and color Doppler angiography was used to evaluate the image fistula maturation status.  Result  A total of 121 patients subjected to distal forearm RC-AVF surgery were enrolled in this study, including 64 cases in CETS group and 57 cases in FETSRAS group. After the creation of fistula for 6 and 12 weeks, the clinical fistula maturation rates were 80.7% and 89.5% respectively in FETSRAS group, higher than those of 64.1% and 73.4% respectively in CETS group (χ2=4.132 and 5.036 respectively, P=0.042 and 0.025 respectively); the image fistula maturation rates were 86.0% and 93.0% respectively in FETSRAS group, higher those of 67.2% and 75.0% respectively in CETS group (χ2=5.833 and 7.066 respectively, P=0.016 and 0.008 respectively). The fistula was used for the first time after 36.6±10.5 days in FETSRAS group, shorter than that after 43.3±13.1 days in CETS group (t=2.800, P=0.006). Variance analysis of repeated measurement data showed that radial artery diameter, cephalic vein diameter and natural blood flow in fistula were higher in FETSRAS group than in CETS group in the postoperative observation period of 12 weeks (F=5.356, 7.356 and 9.154 respectively; P=0.022, 0.008 and 0.003 respectively).  Conclusion  Functional end-to-side anastomosis with radial artery superficial displacement to create the RC-AVF in the distal forearm obtains a shorter fistula maturation period and a higher fistula maturation rate as compared with those using conventional end-to-side anastomosis.

Key words: Arteriovenous fistula, Radial artery superficial displacement, Functional end-to-side anastomosis, Conventional end-to-side anastomosis, Maturation