{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T10:35:19Z","timestamp":1792924519934,"version":"4.5.0"},"reference-count":25,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The optimal anastomotic configuration for distal radiocephalic arteriovenous fistula (AVF) creation remains debated, particularly regarding the role of distal venous outflow preservation. This randomized controlled trial compared latero-lateral AVF without distal vein ligation (LL-AVF) versus latero-lateral AVF with distal vein ligation (LLT-AVF) to assess early maturation and hemodynamic performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a prospective randomized study including 60 patients with end-stage kidney disease undergoing first distal radiocephalic AVF. Patients were randomized 1:1 to LL-AVF or LLT-AVF. Preoperative duplex ultrasound mapping and standardized surgical technique were used in all cases. The primary endpoint was functional AVF maturation at 30\u2009days, defined as brachial artery flow \u2a7e500\u2009mL\/min and venous diameter \u2a7e5\u2009mm. Secondary endpoints included brachial artery flow, venous diameter, and resistance index (RI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Baseline demographic, clinical, and vascular characteristics were comparable between groups. Overall 30-day maturation rate was 75%, with no significant difference between LL-AVF and LLT-AVF (71% vs 77%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.639). Mean brachial artery flow was 967.1\u2009\u00b1\u2009421.8\u2009mL\/min in the LL group and 1028.5\u2009\u00b1\u2009444.2\u2009mL\/min in the LLT group (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.303). Venous diameter was similar between groups (5.2\u2009\u00b1\u20090.85\u2009mm vs 5.4\u2009\u00b1\u20090.89\u2009mm;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.148). One case of venous congestion occurred and was successfully managed with distal vein ligation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Latero-lateral radiocephalic AVF with or without distal vein ligation results in comparable early maturation rates and similar hemodynamic outcomes at 30\u2009days. Although distal vein ligation is associated with a lower early resistance index, this does not translate into improved functional maturation. Preservation of distal venous outflow appears to be a safe and effective alternative strategy in distal AVF creation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11297298261477791","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:18:39Z","timestamp":1787750319000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Distal vein ligation in radiocephalic arteriovenous fistula creation: A randomized trial of hemodynamic impact and early maturation"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1072-4005","authenticated-orcid":false,"given":"Marco","family":"Taurisano","sequence":"first","affiliation":[{"name":"UO Nephrology, Dialysis, and Transplant Hospital \u201cSanta Caterina Novella\u201d Galatina, Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cosma","family":"Cortese","sequence":"additional","affiliation":[{"name":"UOC Nephrology, Dialysis, and Transplant Hospital \u201cPoliclinico di Bari\u201d, Bari, Puglia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Mancini","sequence":"additional","affiliation":[{"name":"UOC Nephrology, Dialysis, and Transplant Hospital \u201cDi Venere\u201d, Bari, Puglia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Napoli","sequence":"additional","affiliation":[{"name":"UOC Nephrology, Dialysis, and Transplant Hospital \u201cFazzi\u201d, Lecce, Puglia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM196611172752002"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2019.12.001"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASN.0000069219.88168.39"},{"key":"e_1_3_2_5_2","doi-asserted-by":"crossref","unstructured":"Lee T. 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Clin J Am Soc Nephrol 2011; 6: 974\u2013981.","journal-title":"Clin J Am Soc Nephrol"},{"key":"e_1_3_2_18_2","first-page":"1753","article-title":"Elderly patients and vascular access outcomes","volume":"9","author":"Vachharajani TJ","year":"2014","unstructured":"Vachharajani TJ, Moist LM, Glickman MH, et al. Elderly patients and vascular access outcomes. Clin J Am Soc Nephrol 2014; 9: 1753\u20131762.","journal-title":"Clin J Am Soc Nephrol"},{"key":"e_1_3_2_19_2","first-page":"115","article-title":"Dialysis therapy in Japan: current status and trends","volume":"21","author":"Masakane I","year":"2017","unstructured":"Masakane I, Taniguchi M, Nakai S, et al. Dialysis therapy in Japan: current status and trends. 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Comparison of outcomes between side-to-side and end-to-side arteriovenous fistula in end-stage renal disease. J Vasc Spec 2015; 2(1): 15\u201319.","journal-title":"J Vasc Spec"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298251382264"},{"issue":"3","key":"e_1_3_2_26_2","first-page":"201","article-title":"Side-to-side anastomosis in fistula creation: the case for preserving distal venous outflow","volume":"14","author":"Hull JE.","year":"2013","unstructured":"Hull JE. Side-to-side anastomosis in fistula creation: the case for preserving distal venous outflow. 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