Factors influencing cumulative patency rate and operation time of the first A-V fistula in hemodialysis patients

Nagatsuma, Katsumi; Matsuzaki, Syoji; Rikiishi, Akihiro; Nagata, Atsufumi; Hieda, Hiroko S.; Matsukawa, S

doi:10.4009/jsdt.37.307

Cited by 1 publication

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“…In Japan, numerous reports analyzing the results following surgery to construct AVF have been produced. [10][11][12][13][14] The problem of whether the desired Q B can or cannot be obtained in an AVF that proceeds normally to maturity is taken up in this report because it has not been discussed elsewhere. Age, gender, underlying disease, types of complications, etc.…”

Section: Analysis Of Results Following Va Surgery and Difficulty Of Amentioning

confidence: 99%

Evaluation of primary failure in native AV‐fistulae (early fistula failure)

Ohira¹,

Kon²,

Imura³

2006

Hemodialysis International

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The most preferable method of vascular access (VA) in maintenance hemodialysis is a native arteriovenous fistula (AVF). Advanced age as well as the rapid increase in underlying diseases such as diabetic nephropathy and nephrosclerosis in these patients also means that the veins and arteries used to establish the AVF have undergone vascular damage, making construction of an AVF more difficult compared with earlier construction. Although there are various conditions under which arterial superficialization or AV graft must be chosen, it remains the rule that the first choice for VA should be AVF whenever possible. To improve postoperative results, it is necessary to reduce malfunctions immediately following surgery. We conducted a survey of 23 dialysis facilities throughout Japan and analyzed data from the past 3 years regarding the functionality of the AVF at initial puncture following construction of 5007 examples of newly constructed AVFs. Upon initial puncture, primary failure (PF) is defined as those cases in which thrombosis or inadequate blood flow occur. Primary failure occurred in 7.6% of the cases in this series, but there was a wide distribution of PF, 0.8% to 23.6%, because of differences in quality among facilities. This difference in PF is probably affected by technical aspects, the main factor being the characteristics of the patient. Survey responses included: (1) vascular damage of the veins and arteries used in creating the AVF and (2) the suitability of the location chosen for construction. In the data collected, many methods were used to repair those primary AFVs in which PF occurred. The salvage rate was 70%. Currently, the most preferable form of VA is AVF adhering to the principle that the proper timing of the choice and construction of AVF should consider the maturation period. To accomplish this, it is vital that vascular mapping be performed preoperatively to construct the AVF. If PF does occur, the cause should be thoroughly investigated and repairs made effectively.

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Section: Analysis Of Results Following Va Surgery and Difficulty Of Amentioning

confidence: 99%