Native Arteriovenous Fistula Creation in Al – Hussein Teaching Hospital

  • Adnan Taan Thamer Medical College / Thi – Qar University ( Thi – Qar, Iraq )
  • Ahmed Abdul – Ameer Daffar Medical College / Thi – Qar University ( Thi – Qar, Iraq )
  • Akeel Salman Yosur Ibn Al – Nafees Teaching Hospital ( Baghdad, Iraq )

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

NKF-K/DOQI Clinical practice guidelines for vascular access: Update 2000. Am J KidneyDis,37:S137-S181,2001.

Chesser AM, Baker LR: Temporary vascular access for first dialysis is common, undesirable and usually avoidable. Clin Nephrol 51:228–232, 1999.

Bander SJ, Schwab SJ: Central venous angioaccess for hemodialysis and its complications. Semin Dial 5:121–128, 1992.

Schwab SJ, Quarles LD, Middleton JP, et al: Hemodialysis-associated subclavian vein stenosis. Kidney Int 33:1156–1159, 1988.

Barrett N, Spencer S, McIvor J, Brown EA: Subclavian stenosis: A major complication of subclavian dialysis catheters. Nephrol Dial Transplant 3:423–425, 1988.

Spinowitz BS, Galler M, Golden RA, et al: Subclavian vein stenosis as a complication of subclavian catheterization for hemodialysis. Arch Intern Med 147:305–307,1987.

Schillinger F, Schillinger D, Montagnac R, Milcent T: Post catheterisation vein stenosis in haemodialysis: Comparative angiographic study of 50 subclavian and 50 internal jugular accesses. Nephrol Dial Transplant 6:722–724, 1991.

. Cimochowski GE, Worley E, Rutherford WE, et al: Superiority of the internal jugular over the subclavian access for temporary hemodialysis. Nephron 54:1541990.

Moss AH, Mclaughlin MM, Lempert KD, Holley JL: Use of a silicone catheter with a Dacron cuff for dialysis short-term vascular access. Am J

Kidney Dis 12:492–498,1988.

DeMeester J, Vanholder R, Ringole S: Factors affecting catheter and technique survival in permanent silicone single lumen dialysis catheters [abstract]. J Am Soc Nephrol,3:361A,1992.

Schwab SJ, Buller GL, McCann RL, et al: Prospective evaluation of a Dacron cuffed hemodialysis catheter for prolonged use. Am J Kidney Dis 11:166–169, 1988.

Suchoki P, Conlon P, Knelson M, et al: Silastic cuffed catheters for hemodialysis vascular access: Thrombolytic and mechanical correction of HD catheters malfunction. Am J Kidney Dis 28:379–386, 1996.

Trerotola SO: Interventional radiology in central venous stenosis and occlusion. SeminIntervRadiol,11:291–304,1994.

Palder SB, Kirkman RL, Whittemore AD, et al: Vascular access for hemodialysis: Patency rates and results of revision. Ann Surg 202:235–239, 1985.

Raju S: PTFE grafts for hemodialysis access: Techniques for insertion and management of complications. Ann Surg 206:666–673, 1987.

Middleton WD, Picus DD, Marx MV, Melson GL: Color Doppler sonography of hemodialysis vascular access: Comparison with angiography. AJR Am J Roentgenol 152:633–639,1989.

Tordoir JHM, Hoeneveld H, Eikelboom BC, Kitslaar PJEHM: The correlation between clinical and duplex ultrasound parameters and the development of complications in arterio-venous fistulae for hemodialysis. Eur J Vasc Surg 4:179–184, 1990.

Tordoir JHM, De Bruin HG, Hoeneveld H, et al: Duplex ultrasound scanning in the assessment of arteriovenous fistulas created for hemodialysis access: Comparison with digital subtraction angiography. J Vasc Surg 10:122–128, 1989.

Glanz S, Bashist B, Gordon DH, et al: Axillary and subclavian vein stenosis: Percutaneous angioplasty. Radiology 168:371–373, 1988.

Brescia M, Cimino J, Appel K, et al: Chronic hemodialysis using venipuncture and a surgically created arteriovenous fistula. N Engl J Med 275:1089–1092, 1966.

Rutherford R (ed): Vascular Surgery, 5th ed. Philadelphia, WB Saunders, 2000.

Miller PE, Tolwani A, Luscy CP, et al: Predictors of adequacy of arteriovenous fistulas in hemodialysis patients. Kidney Int 56:275–280, 1999.

Palder SB, Kirkman RL, Whittemore AD, et al: Vascular access for hemodialysis: Patency rates and results of revision. Ann Surg 202:235–239, 1985.

Kinnaert P, Vereerstraeten P, Toussaint C, Van Geertruyden J: Nine years’ experience with internal arteriovenous fistulas for hemodialysis: Study of some

factors influencing results. Br J Surg 64:242–246, 1977.

Kherlakian GM, Roedersheimer LR, Arbaugh JJ, et al: Comparison of autogenous fistula versus expanded polytetrafluoroethylene graft fistula for angioaccess in hemodialysis. Am J Surg 152:238–243, 1986.

Silva MB, Hobson RW, Pappas PJ, et al: Vein transposition in the forearm for autogenous hemodialysis access. J Vasc Surg 26:981–988, 1997.

Dagher F, Gelber R, Ramos E, et al: The use of basilic vein and brachial artery as an A-V fistula for long term hemodialysis. J Surg Res 20:373–376, 1976.

Illig KA, Orloff M, Lyden SP, et al: Transposed saphenous vein arteriovenous

fistula revisited: New technology for an old idea. Cardiovasc Surg 10:212–215, 2002.

Albers F: Causes of hemodialysis access failure. Adv Ren Replace Ther 1:107–118,1994.

Windus DW: Permanent vascular access: A nephrologist’s view. Am J Kidney Dis 21:457–471,1993.

Owens ML, Stabile BE, Gahr JA, Wilson SE: Vascular grafts for hemodialysis: Evaluation of sites and materials. Dial Transplant 8:521–530, 1979

Mandel ST, McDougal EG: Popliteal artery to saphenous vein vascular access for hemodialysis. Surg Gynecol Obstet 160:358–359, 1985.

Connolly JE, Brownell DA, Levine EF, et al: Complications of renal dialysis access procedures. Arch Surg 119:1325–1328, 1984.

A. Rabbani and colleagues, Department of surgery, School of Medicine, Medical sciences / University of Tehran, Tehran, Iran.

Published
2021-03-22
Section
Articles