Abstract: Ｏｂｊｅｃｔｉｖｅ：To evaluate the effect of modified functional end-to-side anastomosis(MFETS)on venous juxta-anastomotic stenosis(VJAS)and function of distal forearm radiocephalic arteriovenous fistula(RC-AVF).
Ｍｅｔｈｏｄｏｌｏｇｙ：A retrospective cohort study was conducted. Patients who underwent distal forearm RC-AVF surgery for the first time in the Department of Blood Purification, the People’s Hospital of Rizhao Affliated to Jining Medical College, from July 2022 to April 2023, were divided into the conventional end-to-side anastomosis(CETS)group and MFETS group according to the different methods of RC-AVF creation. The incidence of the VJAS, the function of RC-AVF and the blood flow properties in juxta-anastomotic vein within 12 months after surgery were compared between the two groups.
Ｒｅｓｕｌｔｓ：A total of 102 patients were included, 59 in the CETS group and 43 in the MFETS group. Within 12 months after surgery,Kaplan-Meier survival analysis and log-rank test showed that the probability of no VJAS in the MFETS group was higher than that in the CETS group(Log-Rank χ2=4.539, P=0.033), the probability of no immature fistula in the MFETS group also higher than that in CETS group(Log-Rank χ2=4.347, P=0.037), and the postoperative patency rate of the fistula in MFETS group better than that in CETS group(Log-Rank χ2=5.231, P=0.022). Color Doppler results showed the hemodynamic disturbance of the juxta-anastomotic veins in CETS group was more serious than that in MFETS group. The blood flow of in CETS group was in a turbulent state, and the blood flow in MFETS group in a spiral laminar flow state.
Ｃｏｎｃｌｕｓｉｏｎ：Compared with applying CETS, applying MFETS in the creation of distal forearm RC-AVF could decrease the hemodynamic disturbance of the juxta-anastomotic cephalic veins, reduce the incidence of the VJAS and improve the patency rate of the RC-AVF.

Key words: arteriovenous fistula, modified functional end-to-side anastomosis, conventional end-to-side anastomosis, venous juxta-anastomotic stenosis