Clinical Analysis of Radiocephalic Fistula Using Side-to-side Anastomosis with Distal Cephalic Vein Ligation

Hong, Sung Yong; Yoon, Young Chul; Cho, Kwang-Hyun; Lee, Yang-Haeng; Han, Il-Yong; Park, Kyung Taek; Ko, Seongmin

doi:10.5090/kjtcs.2013.46.6.439

Cited by 11 publications

(11 citation statements)

References 13 publications

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“…[7] When we consider early complication rates we saw that high thrombosis rates especially in radiocephalic location were associated with anatomical limitations of surgery in this area where also most of bleeding and hematoma formations occurred. Radiocephalic location was announced in the literature as most common location for thrombosis in early period [8] as well. Radiocephalic location being most common choice of surgeons for fistula creation causes reasonable high rates for complications like hematoma and bleeding so that induces early thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Complications of Arteriovenous Fistula Created for Hemodialysis Access and Treatment Approaches

Demiral

Turkoglu

Türkoğlu

2017

EJMO

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Objectives:Patients with chronic renal failure who are treated with hemodialysis need a patent arteriovenous fistula (AVF). This study was an analysis to determine the best approach to prevent complications and provide treatment. Methods: In this retrospective study, a total of 437 AVF patients' medical records and postoperative epicrisis with 4 years of clinical follow-up were evaluated. The preferred method of anastomosis surgery was the end-to-side technique. Complications were divided into categories of early (seen within 48 hours), and late (after 48 hours). Results: Of 437 patients, 288 (65.9%) were men, and the remaining 149 (34.1%) were women. The mean age was 46 years (range: 20-72 years). The locations of fistulas were snuffbox (n=42; 8.5%), radiocephalic (n=298; 60.9%), brachiocephalic (n=126; 25.6%), and brachiobasilic (n=25; 5%). Early complications were thrombosis (n=57; 69.5%), bleeding (n=14; 17%), and hematoma (n=11; 13.4%). Late complications observed were thrombosis/stenosis (n=25; 39.6%), venous hypertension (n=4; 6.3%), aneurysmatic dilatation (n=12; 19%), infection (n=6; 9.5%), bleeding/hematoma (n=7; 11.1%), arterial steal syndrome (n=4; 6.3%), congestive heart failure (n=1; 1.5%), seroma (n=2; 3.1%), and neuropathy (n=2; 3.1%). The most frequent of 145 total complications observed during the follow-up period was thrombosis (n=82; 16.7%). Conclusion:The benefits of ultrasound assistance in both the control and treatment of bleeding was also a supportive measure for the management of complications, such as steal syndrome, as it can be used to develop the best treatment strategy by considering flow velocities, or in the case of venous hypertension, to detect central stenosis. Embelectomy with re-operation may be preferred in a case of thrombosis, rather than embelectomy alone, as it is a time-consuming procedure and was reported in our clinic to be less effective when a standalone procedure.

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Section: Discussionmentioning

confidence: 99%

Complications of Arteriovenous Fistula Created for Hemodialysis Access and Treatment Approaches

Demiral

Turkoglu

Türkoğlu

2017

EJMO

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“…Some groups perform SS anastomosis technique but with distal vein ligation (SE functionality), not included in this study. 3 Referring to the elbow, SS anastomosis (usually brachiobasilic) can provide higher flow with more matured distal usable veins, 4 avoiding proximal basilic vein superficialization, reaching shorter time to access puncture, less operative complications and expected better patency, compared to SE brachiobasilic fistula with vein superficialization. 5 However, with SS anastomosis there is a higher risk of AVF-induced ischemia, vein approximation, and mobilization is more difficult, and there is a higher risk of distal venous hypertension, without clear published differences in patency.…”

Section: Introductionmentioning

confidence: 99%

“…Some groups perform SS anastomosis technique but with distal vein ligation (SE functionality), not included in this study. 3…”

Section: Introductionmentioning

confidence: 99%

Comparison of side-to-end vs. side-to-side proximal arteriovenous fistula anastomosis in chronic renal failure patients

et al. 2019

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Introduction Anastomotic creation of autogenous arteriovenous fistulas can be performed in different ways, side-to-end or side-to-side. However, there is a paucity of evidence to recommend them. The aim of this study is to compare both anastomosis types in elbow arteriovenous fistulas. Material and methods A prospective observational national multicenter study (ISRCTN62033470) was designed, including patients receiving a native arteriovenous fistula in the elbow using side-to-end or side-to-side anastomosis, between September, 2016 and September, 2017, with six-month postoperative follow-up period. Patient characteristics, surgical details, and follow-up data (primary, assisted primary and secondary patency, maturation, functionality, complications) were recorded and compared between both anastomosis groups using Kaplan–Meier curves estimations, at one and six-month follow-up, and finally a multivariate analysis with Cox regression was performed. Results Three centers participated in the study, including 133 cases (96 side-to-end, 37 side-to-side). The cephalic vein was more often used for side-to-end (58.3%) and basilic for side-to-side (78.4%; P < 0.001). Side-to-end anastomoses were faster to create (65.1–75.1 min; P = 0.009). During follow-up, 23 cases were lost (transplanted, dead, ligated, or lost), with no differences at one month. At six months, primary patency was better for the side-to-end group (78.5 − 55.9%; P = 0.038), but it was not confirmed as an independent predictor in the multivariate analysis. Furthermore, no significant differences in assisted primary or secondary patency, maturation or functionality were seen. Patients with side-to-side anastomosis more often required vein superficialization (2.1–16.2%; P = 0.002) and presented more frequent puncture hematomas (4.9–30.0%; P = 0.015). Conclusions Anastomosis type was not significantly related to different outcomes in the follow-up. Even though side-to-end anastomosis showed better primary patency at six months with lower need of vein superficialization and fewer puncture hematomas during follow-up, it was not confirmed as an independent predictor in the multivariate analysis, and similar assisted primary and secondary patency, maturation, and functionality rates have been seen after arteriovenous fistula creation.

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“…Different studies have reported different incidences of complications among these types of AVF. End-to-end anastomosis has the lowest fistula maturation rate, and arterial end-to-venous side fistula has the Risk of venous hypertension [4] . Vein end-to-arterial side anastomosis (ETS) has the highest proximal venous flow and a relatively low risk of venous hypertension.…”

Section: Introductionmentioning

confidence: 99%

“…Vein end-to-arterial side anastomosis (ETS) has the highest proximal venous flow and a relatively low risk of venous hypertension. Side-to-side (STS) anastomosis is the most commonly used technique and has been described to be the easiest www.jmscr.igmpublication.org Impact Factor (SJIF): 6.379 Index Copernicus Value: 79.54 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v6i11.02 to construct technically [4] , however, this procedure has the risk of venous hypertension and carries a high risk of steal syndrome [5] .…”

Section: Introductionmentioning

confidence: 99%

Comparison of Side to Side vs End to Side Arteriovenous Fistula in upper limb for Hemodialysis

Das¹

2018

jmscr

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Introduction: Various methods of arteriovenous fistula (AVF) creation are in vogue, each having their own pros and cons. This study is aimed at comparing two most common methods of AVF creation -side to side (STS) and end to side (ETS). Materials and Methods: This retrospective comparative study was conducted between January 2017 to January 2018. 57 patients were included in the study-they underwent AVF creation either by STS or by ETS method. Results: All total primary failure rate in the study was 12.28%, there was no statistically significant difference among two groups in regards to demography, operative time or complications except the finding that ETS has significant lower rate of postoperative venous hypertension than STS group. Conclusion: STS AVF has significantly higher rate of venous hypertension than ETS AVF.

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Clinical Analysis of Radiocephalic Fistula Using Side-to-side Anastomosis with Distal Cephalic Vein Ligation

Cited by 11 publications

References 13 publications

Complications of Arteriovenous Fistula Created for Hemodialysis Access and Treatment Approaches

Complications of Arteriovenous Fistula Created for Hemodialysis Access and Treatment Approaches

Comparison of side-to-end vs. side-to-side proximal arteriovenous fistula anastomosis in chronic renal failure patients

Comparison of Side to Side vs End to Side Arteriovenous Fistula in upper limb for Hemodialysis

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