• J Formos Med Assoc · Mar 2024

    Computer-assisted image analysis of preexisting histological patterns of the cephalic vein to predict wrist arteriovenous fistula non-maturation.

    • Jeng-Wei Chen, Mao Ting, Po-Ya Chang, Chiau-Jing Jung, Chin-Hao Chang, Shi-Yu Fang, Li-Wei Liu, Kelvin Jeason Yang, Sz-Han Yu, Yih-Sharng Chen, Nai-Hsin Chi, Ron-Bin Hsu, Chih-Hsien Wang, I-Hui Wu, Hsi-Yu Yu, and Chih-Yang Chan.
    • Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
    • J Formos Med Assoc. 2024 Mar 15.

    BackgroundWe used computer-assisted image analysis to determine whether preexisting histological features of the cephalic vein influence the risk of non-maturation of wrist fistulas.MethodsThis study focused on patients aged 20-80 years who underwent their first wrist fistula creation. A total of 206 patients participated, and vein samples for Masson's trichrome staining were collected from 134 patients. From these, 94 patients provided a complete girth of the venous specimen for automatic image analysis. Maturation was assessed using ultrasound within 90 days after surgery.ResultsThe collagen to muscle ratio in the target vein, measured by computer-assisted imaging, was a strong predictor of non-maturation in wrist fistulas. Receiver operating characteristic analysis revealed an area under the curve of 0.864 (95% confidence interval of 0.782-0.946, p < 0.001). The optimal cut-off value for the ratio was 1.138, as determined by the Youden index maximum method, with a sensitivity of 89.0% and specificity of 71.4%. For easy application, we used a cutoff value of 1.0; the non-maturation rates for patients with ratios >1 and ≤ 1 were 51.7% (15 out of 29 patients) and 9.2% (6 out of 65 patients), respectively. Chi-square testing revealed significantly different non-maturation rates between the two groups (X2 (1, N = 94) = 20.9, p < 0.01).ConclusionComputer-assisted image interpretation can help to quantify the preexisting histological patterns of the cephalic vein, while the collagen-to-muscle ratio can predict non-maturation of wrist fistula development at an early stage.Copyright © 2024 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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