Outcome of thigh arterio venous fistulae for haemodialysis in end stage renal failure (original) (raw)
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Creation of Arterio-Venous Fistula in Chronic Renal Failure Patients
https://www.ijrrjournal.com/IJRR\_Vol.6\_Issue.1\_Jan2019/Abstract\_IJRR0018.html, 2019
Aim: To analyze the method of creating AV fistula and factors affecting its functioning. Material and methods: The study was carried out between August 2016 and July 2018 on 50 patients with chronic renal failure. They were subjected to side to side AV fistula under local anaesthesia. Various parameter of operative procedure and outcome of procedure were analysed. Results: Mean operative time of procedure was 46 minutes. The success rate of AV fistula creation was 80%. In those patients with failure 50% had diabetes mellitus and 20 % had ischemic heart disease. Conclusion: Arteriovenous fistula for haemodialysis has reasonably good success rate with fewer complications.
2012
Patients with end-stage renal disease should have arteriovenous fistula (AVF) formation 3 to 6 months prior to commencing hemodialysis (HD). However, this is not always possible with strained health care resources. We aim to compare autologous proximal AVF (PAVF) with distal AVF (DAVF) in patients already on HD. Primary end point is 4-year functional primary. Secondary end point is freedom from major adverse clinical events (MACEs). , out of 495 AVF formations, 179 (36%) patients were already on HD. These patients had 200 AVF formations (49 DAVF vs 151 PAVF) in arms in which no previous fistula had been formed. No synthetic graft was used. Four-year primary functional patency significantly improved with PAVF (68.9% + SD 8.8%) compared to DAVF (7.3% + SD 4.9%; P < .0001). Five-year freedom from MACE was 85% with PAVF compared to 40% with DAVF (P < .005). Proximal AVF bestows long-term functional access with fewer complications compared to DAVF for patients already on HD.
A multicentre analysis of the outcome of arteriovenous fistula in maintenance haemodialysis
Seminars in Dialysis, 2020
Introduction: Arteriovenous fistulas (AVF) are the preferred choice for vascular access in hemodialysis. We aim to identify factors that may contribute to AVF failure. Methods: Data regarding AVF survival were collected from 441 patients. All AVFs were either radial or brachial, of the end-to-side variety. Parameters studied were age, gender, diabetes mellitus, hypertension prior to end-stage kidney disease (ESKD), site of fistula, blood flow rate, venous pressure, dialysis vintage and frequency, needle gauge used during dialysis, year of fistula creation, and details of fistula failure.
Clinical Practice, 2016
Background: There is gradual increase in need for hemodialysis, as there is gradual increase in the end stage renal disease in India. Permanent vascular access in the patient with end stage renal disease on hemodialysis is provided through a central venous catheter, arteriovenous graft, or arteriovenous fistula. The aim of this study was to evaluate the site, results and postoperative complications of arteriovenous fistula creation in our hospital. Method: It was a retrograde study conducted at Seth Sukhlal Karnani Memorial (SSKM) hospital, Institute of PostGraduate Medical Education and Research (IPGMER), Kolkata, between 1st July 2006 and 30th August 2011. All patients, with end stage renal disease requiring long term vascular access for haemodialysis, were included in the study. In most of the patients radio-cephalic fistulae were created in the left forearm, in some on right forearm, just above the wrist joint, and in some patients brachiocephalic or brachiobasilic arteriovenous fistulae were created. Results: 375 patients were studied; 292 (77.86%) males and 83(22.14%) females, with male to female ratio of 3.52:1. Distribution of co-morbid factors showed diabetes in 225 (60.0%), hypertension in 150 (40%) patients. Radio-cephalic fistula was done in 295 patients and brachiocephalic fistula in 80 patients. In 5% dominant hand was used and for remaining 95% of the patients fistula was created on non-dominant hand. Arterio-venous fistula was successful at 6 weeks in 95%, at 2 years in 90% and at 5 years in 85% patients. In 5% cases, failure in first 6 weeks was because of primary failure or wound infections and at 2-5 years failure due to stenosis of cephalic vein by repeated punctures and thrombosis. In failed patients redo procedure was carried out successfully at another (cubital) site. Conclusion: Radio-cephalic arteriovenous fistula in patients with end stage renal disease requiring long term vascular access for haemodialysis remains the procedure of choice if done by experienced hands.
Early versus late arterio-venous fistulae: impact on failure rate
Journal of Ayub Medical College, Abbottabad : JAMC
Haemodialysis is the primary mode of renal replacement therapy for patients of end stage renal disease. The most important determinant for effective haemodialysis is a reliable vascular access. Arterio-venous (AV) fistula is the closest to be an ideal long-term haemodialysis vascular access. The creation of fistulas or grafts is recommended before starting haemodialysis, this study was undertaken to determine the impact of timing of AV fistula creation on its failure rate. It is a descriptive study. All patients with chronic kidney disease (CKD) reporting to Armed Forces Institute of Urology (AFIU) and Military Hospital (MH) Rawalpindi from January 2008 to October 2009 in whom vascular access was created were included. The patients were followed prospectively and a complete data about their haemodialysis and vascular access was maintained. A total of 168 permanent accesses were created in 112 patients in this study. The mean duration of follow-up was 14.05 +/- 4.45 months. Early acc...
International Surgery Journal, 2016
INTRODUCTION Hemodialysis fistulas are surgically created communications between an artery and vein in an extremity.Several studies indicate that about 30% of hospitalizations are caused by construction and complications of vascular access. 1 Direct arteriovenous communications are called native arteriovenous fistulas. Prosthetic hemodialysis access arteriovenous grafts can also be used as a means of communication between an artery and vein. The access that is created is routinely used for hemodialysis. The AVF was first described and used as a reliable form of hemodialysis (HD) vascular access by Brescia et al in 1966. 2 A shift in the treatment of hemodialysis patients occurred when James EC et al noted that arteriovenous fistulas caused by trauma in Korean war veterans did not have significant effects on their health and this lead to his proposal that ABSTRACT Background: The study was conducted to assess the various complications which are encountered while creating arteriovenous fistula and post operatively during the period when fistula matures. Also the study was intended to study the failure rate and the importance of physical examination to assess vessel caliber clinically. Methods: The study comprised of 83 patients suffering from chonic renal failure and requied arteriovenous fistula for carrying out hemodialysis. The arteriovenous fistulas were created under local anesthesia, observing all precautions and end to side anastomosis was made after dissecting the vein and the artery. Results: The most common difficulty encountered at surgery was when cephalic vein was of very small caliber and we had to give a small longitudinal incision in the wall of vein or do cheatle manouvre to make the anastomosis adequate. In five cases we started for radiocephalic fistula but had to convert to brachiocepphalic fistule as arteriovenous anstomoosis was not possible between the radial artery and the cephalic vein. There were no major complications except redness and inflamation in five cases and pus formation in one case. Inflamation subsided with higher antibiotics and pus had to be drained resulting in satisfactory recovery.Most of the fistulas started well with good thrill and by the end of one month 69 out 83 arteriovenous fistulas were functioning well with a patency rate of 83.13%. Conclusions: There are no major complications after creating arteriovenous fistula and it is imperitive to do physical examination preoperatively to assess the vessel wall. In doubtful cases color Doppler may be got done for this. Postoperative precautions need to be observed for maturation of AV fistula.
[Arteriovenous fistulas for hemodialysis in patients with chronic renal failure]
Polski przeglad chirurgiczny, 1977
INTRODUCTION Hemodialysis fistulas are surgically created communications between an artery and vein in an extremity.Several studies indicate that about 30% of hospitalizations are caused by construction and complications of vascular access. 1 Direct arteriovenous communications are called native arteriovenous fistulas. Prosthetic hemodialysis access arteriovenous grafts can also be used as a means of communication between an artery and vein. The access that is created is routinely used for hemodialysis. The AVF was first described and used as a reliable form of hemodialysis (HD) vascular access by Brescia et al in 1966. 2 A shift in the treatment of hemodialysis patients occurred when James EC et al noted that arteriovenous fistulas caused by trauma in Korean war veterans did not have significant effects on their health and this lead to his proposal that ABSTRACT Background: The study was conducted to assess the various complications which are encountered while creating arteriovenous fistula and post operatively during the period when fistula matures. Also the study was intended to study the failure rate and the importance of physical examination to assess vessel caliber clinically. Methods: The study comprised of 83 patients suffering from chonic renal failure and requied arteriovenous fistula for carrying out hemodialysis. The arteriovenous fistulas were created under local anesthesia, observing all precautions and end to side anastomosis was made after dissecting the vein and the artery. Results: The most common difficulty encountered at surgery was when cephalic vein was of very small caliber and we had to give a small longitudinal incision in the wall of vein or do cheatle manouvre to make the anastomosis adequate. In five cases we started for radiocephalic fistula but had to convert to brachiocepphalic fistule as arteriovenous anstomoosis was not possible between the radial artery and the cephalic vein. There were no major complications except redness and inflamation in five cases and pus formation in one case. Inflamation subsided with higher antibiotics and pus had to be drained resulting in satisfactory recovery.Most of the fistulas started well with good thrill and by the end of one month 69 out 83 arteriovenous fistulas were functioning well with a patency rate of 83.13%. Conclusions: There are no major complications after creating arteriovenous fistula and it is imperitive to do physical examination preoperatively to assess the vessel wall. In doubtful cases color Doppler may be got done for this. Postoperative precautions need to be observed for maturation of AV fistula.
The Ankle Arterio-venous Fistula: an Approach to Gaining Vascular Access for Renal Haemodialysis
European Journal of Vascular and Endovascular Surgery, 2001
Two short, longitudinal incisions were made mean arterio-venous (AV) fistula at the ankle, between dially in the distal calf, forming a broad skin bridge the posterior tibial artery (PTA) and the long saover the previously marked vessels (Fig. 1). The LSV phenous vein (LSV), where multiple access placements was followed down on to the foot and mobilised have failed already in the upper extremities. gently in a vascular sling. Any side branches were tied carefully. The PTA was mobilised in similar fashion from its bed. The patient was heparinised intravenously, prior to clamping of the vessels. The LSV Patients and Techniques was ligated and divided distally in the foot. The cut end was swung under the skin bridge to lie alongside Three patients (male, ages 25, 35 and 69 years) with the PTA, under no tension. Using magnification no further dialysis access possible in their upper extremities, were selected to receive an ankle AV fistula. (loupes) an ''end to side'' AV anastomosis was comA duplex ultrasound scan was carried out to confirm: pleted using a double ended 7/0 prolene vascular suture (Ethicon Ltd, U.K.
Endovascular Creation of Haemodialysis Arteriovenous Fistula
Acta Clinica Croatica, 2021
department of diagnostic and interventional radiology, Clinical hospital merkur; 3 department of diagnostic and interventional radiology, Sisters of mercy university hospital Center SummAry-Surgical fistulas have been used to create dialysis access for over 50 years in chronic kidney disease patients. however, due to problems like slow maturation and a high risk of thrombosis or stenosis, results remain sub-optimal with high intervention and surgery rates to maintain patency. Endovascular methods for fistula creation were invented recently to resolve these issues, allowing haemodialysis patients to have an alternative non-surgical option, with two different devices currently available. Endovascular creation of A-v fistulas is involved with minimal vessel trauma, which could be the reason for encouraging initial results demonstrating high technical success rates, low intervention rates, and good patient satisfaction. This article describes the technical aspects of these procedures, patient selection as well as trial results, and the status of endovascular arteriovenous fistula creation.