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

Das, Dr Sumanta

doi:10.18535/jmscr/v6i11.02

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…All studies were thoroughly screened to identify 23 articles related to the review topic. Seven studies were excluded and 16 studies were analyzed in our systematic review and meta-analysis (8)(9)(10)(11)(12)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26).…”

Section: Resultsmentioning

confidence: 99%

Comparison of end-to-side versus side-to-side anastomosis in upper limb arteriovenous fistula in hemodialysis patients: A systematic review and meta-analysis

Zhou

2023

Front. Surg.

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ObjectiveIt is currently unclear if the anastomosis technique impacts the patency of upper arm arteriovenous fistula (AVF) in hemodialysis patients. This review compared outcomes of end-to-side and side-to-side anastomosis for AVF fistula in hemodialysis patients.MethodsPubMed, CENTRAL, Web of Science, and Embase were searched for all types of studies published between 1st January 2000 to 3rd September 2022. Patency rates at 6, 12 months, maturation time, and complications were compared between ETS and STS groups.ResultsSixteen studies including six randomized controlled trials (RCTs) were included. Meta-analysis showed no difference in patency rates between ETS and STS group at 6 months (OR: 1.15 95% CI: 0.72, 1.83 I2 = 52% p = 0.56) but better patency with STS at 12 months (OR: 0.63 95% CI: 0.41, 0.95 I2 = 21% p = 0.03). The difference was non-significant in a subgroup analysis of RCTs and non-RCTs. In the absence of distal vein ligation in the STS group, the ETS group had significantly better patency at 6 months but with distal vein ligation, STS had higher patency at 12 months. Meta-analysis demonstrated no difference in maturation time between the two groups (MD: 0.10 95% CI: 0.29, 0.49 I2 = 89% p = 0.61). Only a descriptive analysis of complications could be carried out with no major difference.ConclusionOur review demonstrates that the STS anastomosis technique with distal vein ligation may result in significantly better patency rates as compared to the standard ETS technique. Data for complication rates are scarce and varied but without any significant differences between the two techniques.

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Section: Resultsmentioning

confidence: 99%

Comparison of end-to-side versus side-to-side anastomosis in upper limb arteriovenous fistula in hemodialysis patients: A systematic review and meta-analysis

Zhou

2023

Front. Surg.

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“…Also, there are higher chances of venous hypertension. 21 22 And one needs to at times ligate the distal venous outflow or its tributaries, to redirect the flow. As with vascular clamp technique, in these series too there were cases of either early thrombosis or failure of AVF to develop a good flow.…”

Section: Discussionmentioning

confidence: 99%

Can We Create an Arteriovenous Fistula for Hemodialysis through 0.5–1.0 cm Incision without Using Vascular Clamps?

Gajiwala

2021

Indian J Plast Surg

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Background A native arteriovenous fistula (AVF) is a gold standard for renal replacement therapy, where regular hemodialysis is the mainstay of survival in the majority of patients suffering from end-stage renal disease. Appropriate vascular clamps are routinely used to occlude an artery and a vein before an arteriotomy or a venotomy is done to prevent blood loss and have a clear field and an ease of anastomosis. The title makes one wonder, is it then possible to create an AVF without using vascular clamps? And through incisions as small as 0.5to 1.0 cm? This is made possible by a very simple new technique, presented here, that helps to occlude vessels to create an AVF through minimal access, and minimize blood loss and postoperative pain. Material and Method Total 622 AVFs were created between 1998 and 2019. With regular forceps or an AVF platform (design given), an AVF was created without using a vascular clamp. Total 321 cases were operated with 0.5 to 1.0 cm and 215 cases within 1.5 cm skin incision approach. Results There were ~85% successful functional fistulas. The blood loss was negligible, and only one in three required pain killer in postoperative period. Conclusion A simple new technique described here makes it possible to create a functional AVF through a small incision, without using vascular clamps.

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

Cited by 2 publications

References 12 publications

Comparison of end-to-side versus side-to-side anastomosis in upper limb arteriovenous fistula in hemodialysis patients: A systematic review and meta-analysis

Comparison of end-to-side versus side-to-side anastomosis in upper limb arteriovenous fistula in hemodialysis patients: A systematic review and meta-analysis

Can We Create an Arteriovenous Fistula for Hemodialysis through 0.5–1.0 cm Incision without Using Vascular Clamps?

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