Short- and long-term evaluation of arteriovenous fistulas for chronic hemodialysis.
One hundred ninety-three internal arteriovenous (A-V) fistulas were performed on patients with renal failure in the last eleven years. The A-V fistulas were divided on the basis of the following: side-to-side between the radial artery and cephalic vein (157 cases); end-to-side between the cephalic vein and radial artery (11 cases); end-to-end between the radial artery and cephalic vein (5 cases); A-V fistulas between the brachial artery and the cephalic, basilic or medial cubital vein (20 cases). The side-to-side A-V fistulas achieved an immediate patency in 88% of cases, lower than each of the other groups. However, the subsequent long-term failure rate was less than the other groups. In addition, satisfactory function was maintained at a high level (93%) during the follow-up period. The end-to-side and end-to-end A-V fistulas showed higher percentages of immediate patency (90% and 100%, respectively), although they were used more often on patients with vascular problems. Diabetic nephropathy was the main factor associated with thrombosis of A-V fistulas.
Cassioumis
D
D
Department of Surgery, School of Medicine, University of Ioannina, Greece.
Fatouros
M S
MS
Siamopoulos
K C
KC
Giannoukas
A D
AD
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000098:blood supply; D001166:Arteriovenous Shunt, Surgical / Q000379:methods; D005069:Evaluation Studies as Topic; D006801:Humans; D008875:Middle Aged; D006435:Renal Dialysis; D012189:Retrospective Studies; D014654:Vascular Patency