Add like
Add dislike
Add to saved papers

Outcomes of arteriovenous fistula reconstruction in vascular access dysfunction.

BACKGROUND: Complications such as stenosis, thrombosis, aneurysmal dilatation, and infection occur in at least one-third of all arteriovenous fistulas (AVFs). Due to these complications, vascular access dysfunction develops in hemodialysis patients.

OBJECTIVES: We investigated AVF rescue operations, which we performed for the pathologies causing dysfunctional vascular access, and outcomes of these operations by surgeon-performed preoperative ultrasound (US) in our clinic.

DESIGN: Retrospective Study.

SETTINGS: Bursa Yüksek Ihtisas Training and Research Hospital Cardiovasculary Surgery Department, Turkey.

PATIENTS AND METHODS: 67 patients who were treated in our clinic due to AVF dysfunction between January 2012 and January 2016 were included in the study. Preoperative US evaluation for dysfunctional AVFs was performed by the surgeon conducting the operation. The patients were divided into 5 groups according to the pathologies such as stenosis, thrombosis, aneurysm, high-flow rate, and deep basilic vein.

MAIN OUTCOME MEASURES: Our goal in all patients with vascular access dysfunction was to maintain the AVF.

SAMPLE SIZE: 67 Patients.

RESULTS: In Group 1 (16 patients) which had stenosis and underwent AVF reconstruction, the 24-month primary patency rate was 81.3%. In Group 2 (9 patients) which had trombosis and underwent AVF reconstruction, the 24-month primary patency rate was 22.2%. In Group 3 (24 patients) which had AVF aneurysm and underwent AVF reconstruction, the 24-month primary patency rate was 70.8%. In Group 4 (10 patients) which had high flow and underwent AVF reconstruction, the 24-month primary patency rate was 90%. In Group 5 (8 patients) which had deep basilic vein and underwent AVF reconstruction, the 24-month primary patency rate was 75%.

CONCLUSION: Leaving patients with vascular access dysfunction to fate (no intervention) or AVF ligation is always simpler and easier. However, it should not be forgotten that paternity for vascular access are limited in these patients. We think that the primary target is to demonstrate AVF by physical examination and surgeon-performed detailed US and to make it again available for hemodialysis by reconstructing dysfunctional AVF using the most appropriate surgical strategy.

LIMITATIONS: Retrospective, small sample size.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app