International survey of radiocephalic arteriovenous fistula: ISRAF survey

Abstract

Aims: The objective of this survey was to encompass the full scope of international practice, entailing all technical, non-technical, preoperative stratification and functional maturation (FM) of RCAVF. Methods: The survey contained n = 19 questionnaires with n = 46 variables completed by n = 85 providers from n = 21 nations across n = 5 continents. The numerical values were subjected to mean with standard error whereas the nominal data to a non-parametric (Kruskal-Wallis & Spearman correlation test) and analysis of variance (ANOVA). The test of homogeneity, & probability was reported 95% confidence intervals (CI) alongside error plots. Furthermore, a decision and higher attribute tree model was constructed based on current survey for higher FM in RCAVF. Results: FM is independently associated with volume of surgeon per year (procedures performed) ( p < 0.01) [High Volume: 73% (95% CI, 68–77%) versus Average volume: 63% (95% CI, 59–66%) vs Low volume: 56% (95% CI, 51–61%)]. FM increased by 8% with every 20 more procedures per group of surgeons on end point of FM. Amongst continents: Australia, America, Asia and South America demonstrated higher FM to Africa & Europe ( p < 0.05). UK possessed a lower FM 58% (95% CI, 48–68%) in comparison to the world & Europe respectively [65% (95% CI, 61–70%) vs 61% (95% CI, 58–-65%)]. There was a positive causal link between angle of anastomosis at 30–76° ( p < 0.01), longitudinal & S-shaped incision & arteriotomy length of 3 & 4 mm to higher FM ( p < 0.05). Conclusion: FM in RCAVF is independently & incrementally associated with the volume of surgeon per year. There is a diverse inclusion, exclusion and technical approach in RCAVF creation. This survey advocates the importance of international collaboration and/or registry in assimilation, consolidate and development of consensus.