External Application Of Traditional Chinese Medicine On Maturation Of Arteriovenous Fistula

Objective: To evaluate the effect of external application of traditional Chinese medicine on maturation of arteriovenous fistula(AVF).Methods: 99 patients with left forearm AVF were randomly divided into the control group(Group A,n = 50)and the treatment group(Group B,n = 49).Color Doppler ultrasound were used to assess patients' forearm vascular before and after 6 weeks of AVF operation.Several parameters,such as radial artery diameter,blood flow,brachial artery diameter,brachial artery flow rate,anastomotic size,and cephalic vein diameter were compared between the two groups.Coagulation was compared before and after 6 weeks of AVF operation.Traditional Chinese medicines,such as Honghua and Danshen,were applied externally on patients in Group B.Traditional Chinese medicines were applied externally on AVF ipsilateral forearm,60 minutes each time,once a day,after the fifth week,a total of 4 weeks.Results: Nine thrombotic incidents happened in 99 enrolled patients.And then,ultrasound data were collected in 45 patients in the group A and 45 patients in group B before and after AVF operation.The maturation rate assessed by ultrasound were 77.5%(38/49)and 70.0%(35/50)in group A and group B,respectively.The clinical maturation rate were 81.6%(40/49)and 74.0%(37/50)in group A and group B,respectively.Inflow radial artery and outflow cephalic venous were all dilated after AVF operation.Several ultrasound parameters,such as velocity of the radial artery,radial artery flow,diameter of the radial artery and venous diameters have significant differences before and after 6 weeks of AVF operation(Table 2);There was significant difference in brachial arterial blood flow between group A and group B((1022.46±482.81)ml/min vs.(828.15±438.85)ml/min)).Other ultrasound parameters,such as diameter of radial artery and brachial artery,velocity of brachial artery,anastomotic size,and diameter of venous outflow have no significant difference between Group A and Group B.There was no significant difference in coagulation between Group A and Group B in the fifth week.Conclusions: External application of traditional Chinese medicine can increase AVF blood flow and may promote the maturation of arteriovenous fistula.