Early follow-up results of arteriovenous fistulae created for hemodialysis

Hikmet Iyem
Çanakkale 18 Mart, Üniversitesi Tip Fakültesi, Turkey

Background: The aim of this study was to evaluate the site, early results, and postoperative complications of arteriovenous fistula (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.

Keywords: end-stage renal failure, arteriovenous fistula, early patency, complications