Prospective analysis of arteriovenous fistula in hemodialysis patients

Abstract

Introduction: Patients of end-stage renal disease (ESRD) are dependent on lifelong dialysis for which an arteriovenous fistula (AVF) is the preferred vascular access. Aim: The aim of this study was to evaluate the site, results, and postoperative complications of AVF creation. Materials and Methods: A prospective study involving 100 patients of ESRD was conducted from July 1, 2015 to August 30, 2017. Cimino–Brescia radiocephalic fistulae were created just proximal to the wrist joint of the nondominant hand. In patients with prior failed attempts of wrist fistulae creation, a brachiocephalic fistula was constructed. Results: Of 100 patients, 77 male and 23 female (M:F = 3.52:1) were studied. Twenty-three patients were diabetic and 40 were hypertensive. Ninety-three patients underwent surgery for radiocephalic fistula, and brachiocephalic fistulae were constructed in seven patients. The dominant side was used in 5% of patients and the nondominant side in 95%. Technical success was 87% after 6 weeks, and at 6 months, a higher (cubital) fistula was performed for the 13% unsuccessful cases. Conclusion: An AVF in patients with an ESRD requiring long-term vascular access for hemodialysis remains the procedure of choice if performed by experienced hands.

Keywords

• arteriovenous fistula
• hemodialysis
• steal syndrome
• thrombosis
• vascular access