Correspondence Address:
Prof. Pawan Agarwal
Department of Surgery, NSCB Government Medical College, Jabalpur, Madhya Pradesh
India

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Sir,

We read with interest an article entitled “Preoperative Factors Predicting the Outcomes of Arteriovenous Fistula (AVF) Surgery” by Pogula et al.[1] It is a nicely written article about preoperative factors predicting the outcome of AVFs in chronic kidney disease patients. Authors rightly concluded that the diameter of vein, artery, and flow rate across the anastomosis were the predominant factor determining the success of the arteriovenous (AV) fistulas. Creation of successful AV fistula with long-term patency is a daunting job, and there is a complex interaction of factors that may affect the patency of an individual AVF. Apart from the factors mentioned in the article, there are many other factors responsible for success/failure of fistula. These include size/type of anastomosis, peroperative blood pressure, thrill immediately after the creation of fistula, configuration of AVF, ability of vein to dilate, venous intimal hyperplasia or calcification, and serum creatinine.[2],[3] Is there any role of preoperative venous mapping by ultrasound? Lok et al.[4] predicted the risk for failure of AV fistula is dependent on age, coronary artery disease, peripheral vascular disease, and race. We would like authors to comment on the impact of these factors on the success of AV fistula.

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