1. Outcomes of three types of native arteriovenous fistula in a single center
- Author
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Eugenio Romano, Stefano Michelagnoli, Emiliano Chisci, Francesco Menici, Nicola Troisi, Leonardo Ercolini, Pierfrancesco Frosini, and Linda M. Harris
- Subjects
Male ,Time Factors ,Complications ,Brachial Artery ,030232 urology & nephrology ,Primary patency ,030204 cardiovascular system & hematology ,Single Center ,0302 clinical medicine ,Mid-arm fistula ,Risk Factors ,Young adult ,Child ,Aged, 80 and over ,Arteriovenous fistula (AVF) ,Graft Occlusion, Vascular ,Middle Aged ,Treatment Outcome ,Italy ,Nephrology ,Child, Preschool ,Radial Artery ,Retreatment ,Female ,Adult ,medicine.medical_specialty ,Adolescent ,Operative Time ,MEDLINE ,Arteriovenous fistula ,Veins ,Surgical methods ,Upper Extremity ,Young Adult ,03 medical and health sciences ,Arteriovenous Shunt, Surgical ,Renal Dialysis ,medicine ,Humans ,Vascular Patency ,End-stage renal disease (ESRD) ,Aged ,Retrospective Studies ,business.industry ,Infant, Newborn ,Infant ,Retrospective cohort study ,medicine.disease ,Surgery ,Operative time ,business - Abstract
Objective To study the outcomes of three different types of native arteriovenous fistula (AVF), the distal (D: radial-cephalic), middle-arm (MA: radial-cephalic) and proximal (P: brachial-cephalic) AVF access creation for hemodialysis patients in a single center. Methods An 8-year retrospective review, from 2006 to 2014, was conducted at a single institution in which the surgical outcomes for three different types of native AVF creation were reviewed. Preoperative duplex vein mapping was obtained in all patients to choose the best vein and site for access. Results There were 317 patients identified with 41 D-AVFs, 120 MA-AVFs and 156 P-AVFs. Younger patients with a lower Charlson's Index were more frequent in the D-AVF group (p = 0.02). Mean operating room time was 15 minutes longer for the MA-AVF group than the two others (p = 0.018). Early failure (thrombosis at 30-day), one-year patency, one-year primary AVF functional patency for the D-AVF, MA-AVF, and P-AVF groups were 2.4% (n = 1), 8% (n = 1), 3.8% (n = 6), (p = 0.14); 97.6% (n = 39), 99% (n = 117), 89% (n = 129), (pConclusions D-AVF is still the gold-standard access for hemodialysis. If D-AVF is not possible, MA-AVF should be always investigated before committing to a P-AVF.
- Published
- 2017