Native Arteriovenous Fistula Creation in Al – Hussein Teaching Hospital
Abstract
Objective : To present the advantages of native arteriovenous fistula creation in comparison with graft AVF creation in patients with chronic renal failure and on regular hemo – dialysis or those with impending end stage renal disease and that searching for a suitable superficial vein for this purpose is mandatory. Patients : This is a prospective study of 50 patients for whom an arteriovenous fistula was created in the upper limb under local anaesthesia over a period of about one year ( from 1st of January 2013 till 1st of December 2013 ). Methods : The case sheets of relevant patients for whom an AVF was created were reviewed to collect information like patient's sex, age, site of AVF, type of anastomosis, etc… Results: AVF creation was offered for different age groups and for both sexes. Side to side anastomosis was carried out for most patients and the preferred site was the cubital fossa between the brachial artery and a nearby superfial vein. The time of first cannulation after AVF creation was variable depending on several factors. Different complications but no mortality had been recorded perioperatively. Conclusions:Native AVF creation is always preferred over graft AVF and every effort was made to search for a suitable superficial vein for the purpose of AVF creation. The elbow region was a suitable option for elderly patients and those with comorbidities despite the fact that the more distal location of AVF is associated with less complications. Side to side anastomosis for AVF creation was the procedure of choice and the non dominant upper limb is prefere if possible.References
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