Resultados tardios da experiência clínica com a fístula arteriovenosa safeno-femoral superficial como acesso à hemodiálise

Abstract

Objectives: To analyze late results of clinical experience with superficial saphenofemoral arteriovenous fistulas (SSFAVF) as access for hemodialysis and their related complications. Methods: From August 1998 through May 2006, 56 fistulas were performed in 48 patients at Hospital de Ensino da Faculdade de Medicina do ABC (FMABC). On eight of them, two fistulas were required. The patients were referred from the Nephrology Service and from the Center of Nephrology and Hypertension (CNH) of Hospital de Ensino da FMABC. The oldest fistula had been carried out 93 months ago, and the most recent, 2 months ago. Participants' mean age was 44.4 years. Procedures were performed in patients without option of access in the upper limbs. The surgical technique consisted of anteriorization and superficialization of the great saphenous vein, in the posterior aspect of the thigh, anastomosed to the superficial femoral artery in the distal portion. SSFAVF were assessed according to the following variables: immediate, early and late results, intraoperative complications, postoperative complications (up to the 30th day), fistula efficacy after start of punctures (facility of punctures, hemodialysis flow, spontaneous venous pressure and dialysis adequacy according to K.T/V) and inherent complications (thrombosis, postpuncture hematoma, distal limb ischemia, cardiac decompensation, puncture pseudoaneurysm, anastomotic pseudoaneurysm, aneurysmal dilatation and infection). Data analysis methods were cumulative patency, using the Kaplan-Meier method, and simple percentage for other results.