Abstract: 【Abstract】Objective The newly created arteriovenous radial- cephalic wrist fistula was observed by Doppler ultrasonography and the blood flow and steal blood phenomenon were recorded, in order to investigate the correlation between blood flow distribution in the fistula and steal blood phenomenon. Methods Forty-four patients with end-to-side radial-cephalic wrist fistula operation for 2～6 weeks were recruited in this study. Doppler ultrasonography was used to measure the blood flow in proximal radial artery, distal radial artery and cephalic vein of the fistula. Steal blood phenomenon was evaluated by color Doppler ultrasonography. According to the steal blood phenomenon, the patients were divided into retrograde flow in the distal radial
artery group (groupⅠ) and antegrade flow in the distal radial artery group (groupⅡ). The blood flow in the proximal and distal radial arteries and cephalic vein of the fistula were compared between the two groups. Results Retrograde flow in the distal radial artery was found in 35 patients (group I) with the steal blood phenomenon rate of 79.5%. Antegrade flow in the distal radial artery was found in 9 patients (group II). The blood flow in the proximal radial arteries of anastomosis orifice was significantly higher in groupⅡ than in group Ⅰ (t=- 2.899, P=0.006). In contrast, the blood flow in the distal radial arteries of anastomosis orifice were significantly lower in groupⅡ than in groupⅠ (t=2.040, P=0.048). The mean blood flow in the cephalic veins had no statistical difference between group II and group I (452.22±170.50 ml/min vs. 500.31±191.49 ml/min; t=0.680, P= 0.500). In the 35 patients with retrograde flow in the distal radial artery (group I), one patient developed dialysis access induced ischemia syndrome, and the blood flow in the distal radial artery was higher than that in the proximal radial artery of anastomosis orifice. Conclusion Steal blood phenomenon is frequently found in arteriovenous fistula. Retrograde flow in the distal radial arteries (steal blood phenomenon) is critical for the maturation of arteriovenous fistula.

Key words: Autogenous arteriovenous fistula, Doppler ultrasonography, Steal blood phenomenon, Hemodynamics