Early follow-up results of arteriovenous fistulae created for hemodialysis

Abstract

Background:The aim of this study was to evaluate the site, early results, and postoperative complications of arteriovenous f istula (AVF) creation procedures for hemodialysis in our clinic.Methods:The hospital records of 384 patients who underwent 411 AVF creation procedures for hemodialysis by the same team at our clinic between February 2008 and January 2010 were included for retrospective analysis. All procedures were performed under local anesthesia with lidocaine. Vasospasm was treated by mechanical dilatation with a probe and topical papaverine.Results:Of our 384 patients, 58.5% were male and 41.5% were female. Mean age was 46 (range 12–72) years. Of the 411 AVF procedures performed, 106 (25.8%) were created at the anatomical snuffbox, 264 (64.3%) were Brescia–Cimino procedures, and 41 (9.9%) were antecubital, brachiocephalic, or brachiobasilic procedures. Twenty-three patients (5.98%) were subjected to more than one surgical intervention due to early thrombosis or failure of AVF. Early patency was found in 94.0% of the AVF created. Twenty-three patients underwent more than one surgical intervention due to early AVF thrombosis or failure. Early AVF failure occurred more often in females (60.8%) than in males (39.2%). Complications were observed in a total of 11.4% patients.Conclusion:Mechanical dilatation of the artery and vein, before starting the anastomosis, as well as the use of vasodilatory agents, could decrease early thrombosis of the fistula, and this method has very high early patency.

Development of prognostic model for fistula maturation in patients with advanced renal failure

“…Miller et al [29] found Ithat the AVF maturation is more successful in men than in women. Similar results were obtained by Gibbons [30] and Iyem [31]. In our study, males were twice as likely to undergo fistula maturation, compared to that of females; the most rational explanation for this difference is the smaller size of vessels in women.…”

Complications of Arteriovenous Fistula Created for Hemodialysis Access and Treatment Approaches

“…Iyem et al, reported the same highest complication rate of thromboses in a broad study population. [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.…”

Clinical profile and early outcome of arteriovenous fistula creation for haemodialysis: Integrated activity in a general surgery unit

“…16 Three patients had arm edema out of which one patient had non functioning fistula since first post operative day and was referred to vascular unit of other centre and edema subsided on its own in other 2 patients. One patient developed haematoma on first post operative day which was evacuated in operation theatre but fistula was functional and was patent at 6months follow up.…”

“…The common complication of AVF surgery is thrombosis. 16 We have not used ultrasound Doppler for our patients due to lack of logistics so we were not able to detect the possible thrombosis causing failure in our unsuccessful cases (n=6).…”