Comparisons among different surgical procedures of vascular access reconstruction with arteriovenous fistula dysfunction

Abstract

Objective To investigate the advantages and disadvantages of different surgical procedures of vascular access reconstruction for end-stage renal disease hemodialysis patients with arteriovenous fistula dysfunction.Methods Three patterns of surgical reconstruction of vascular access were carried out in 241 end-stage renal disease hemodialysis patients with arteriovenous fistula dysfunctioa There were 92 cases of original fistula re-vascularized in proximal part(group A).87 cases of angioplasty using embolectomy balloon percutaneous tube(including fistula embolectomy and angioplasty,group B),and 62 cases of establishing alternative vascular access(group C).The success rate,patency rate,average blood flow,complications of three surgical procedures were compared during the following two years after surgeries.Results The success rate in groups A,B,and C was 93.5%,94.2%and 96.8%,the patency rate was 80.4%,82.7%and 80.6%,and the average blood flow in fistula was(250±24) ml/min,(240 ±21) ml/min and(230 ± 16) ml/min respectively,with no statistically significant difference.There were no serious complications,such as congestive heart failure or steal syndrome.Conclusions For hemodialysis patients with arteriovenous fistula dysfunction,reconstruction of vascular access should be based on vascular conditions to select an appropriate surgical method.As a kind of effective and minimally invasive surgical method,percutaneous angioplasty can maximally retain the vascular resources of patients.

Keywords

• Arteriovenous fistula
• Vascular access
• Hemodialysis