Abstract: 【Abstract】Objective To explore the ultrasonic examination for the evaluation of maturation process of newly established radial- cephalic arteriovenous fistula (RC-AVF) within 24 weeks after surgery. Method In this single center clinical study, RC-AVFs performed from October 2016 to January 2018 were included in this study. Ultrasound follow-up examinations were performed after surgery. Patients were divided into patency group and failure group. The ultrasonic parameters at different follow-up time points were compared. ROC curve was used to analyze the diagnostic value of ultrasonic monitoring parameters. Results The patency rate of RC-AVF at the 24th week was 71.43%. The internal diameter of brachial artery (t=-2.338, P=0.029) and cephalic vein (t=- 4.792, P=0.003) increased gradually within 4 weeks after surgery in patency group, while the changes were not significant between 4th to 24th week (P> 0.050). The internal diameter of cephalic vein and its blood flow were always significantly different between the two groups during the follow-up period (P ＜0.05). When the optimal cut-off value of cephalic vein diameter was set at 4.28mm, the sensitivity and specificity were 81.82% and 86.67% respectively for predicting maturation of AVF and AUC=0.882; when the optimal cut-off value of blood flow in cephalic vein was set at 701.580ml/min, the sensitivity and specificity were 72.73% and 93.33% respectively for predicting maturation of AVF and AUC=0.873. Conclusion The newly established RC-AVF matures rapidly within 4 weeks after surgery. The internal diameter of cephalic vein and its blood flow were the main parameters of RC-AVF maturity. The optimal cut-off values for the diagnosis of RC-AVF maturation were internal diameter of cephalic vein 4.28mm and blood flow in cephalic vein 701.580ml/min respectively.

Key words: Radial-cephalic arteriovenous fistula, Color Doppler ultrasound, Maturation, Internal diameter of cephalic vein