Title: Comparison of Side to Side vs End to Side Arteriovenous Fistula in upper limb for Hemodialysis

Author: Dr Sumanta Das

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i11.02

Abstract

Introduction: Various methods of arteriovenous fistula (AVF) creation are in vogue, each having their own pros and cons. This study is aimed at comparing two most common methods of AVF creation - side to side (STS) and end to side (ETS).

Materials and Methods: This retrospective comparative study was conducted between January 2017 to January 2018. 57 patients were included in the study-they underwent AVF creation either by STS or by ETS method.

Results: All total primary failure rate in the study was 12.28%, there was no statistically significant difference among two groups in regards to demography, operative time or complications except the finding that ETS has significant lower rate of postoperative venous hypertension than STS group.

Conclusion: STS AVF has significantly higher rate of venous hypertension than ETS AVF.

Keywords: Arteriovenous fistula,  hemodialysis, venous hypertension.

References

  1. Brescia MJ, Cimino JE, Appel K, Hurwich BJ. Chronic hemodialysis using venipuncture and a surgically created arteriovenous fistula. N Engl J Med. 275:1089–1092. 1966
  2. Vascular Access 2006 Work Group. Clinical practice guidelines for vascular access. Am J Kidney Dis. 48 (Suppl 1):S176–S247, 2006
  3. Rayner HC, Pisoni RL, Gillespie BW et. al. Creation, cannulation and survival of arteriovenous fistulae.data from the Dialysis Outcomes and Practice Patterns Study.Kidney Int. 63(1):323-30, 2003
  4. Hong Sung Yong , Young Chul Yoon, Kwang-Hyun Cho al. Clinical Analysis of Radiocephalic Fistula Using Side-to-Side Anastomosis with Distal Cephalic Vein Ligation. The Korean Journal of Thoracic and Cardiovascular Surgery . 46.6: 439–443, 2013
  5. Bashar K , Medani M , Bashar H al. End-To-Side versus Side-To-Side Anasto-mosis in Upper Limb Arteriovenous Fistula for Dialysis Access: A Systematic Review and a Meta-Analysis. Ann Vasc Surg. 47:43-53, 2018
  6. MacRae JM, Oliver M, Clark E, et. al. Arteriovenous Vascular Access Selection and Evaluation. Canadian Journal of Kidney Health and Disease. 3:2054358116669125, 2016
  7. Tellis VA, Veith FJ, Sobermann RJ, Freed SZ, Gliedman ML. Internal arteriovenous fistula for hemodialysis. Surg Gynecol Obstet. 132: 866–870,1971
  8. Konner K. A primer on the AV fistula—Achilles' heel, but also Cinderella of haemodialysis. Nephrol Dial Transplant. 14: 2094–2098,1999
  9. Klaus Konner. The anastomosis of the arteriovenous fistula—common errors and their avoidance, Nephrology Dialysis Transplantation. 17(3): 376–379, 2002,
  10. Marx AB, Landmann J, Harder FH. Surgery for vascular access. Curr Probl Surg. 27:1–48, 1990
  11. Al-Jaishi AA, Oliver MJ, Thomas SMal. Patency rates of the arteriovenous fistula for hemodialysis: a systematic review and meta-analysis. Am J Kidney Dis. 63(3):464-478, 2014
  12. Valenti D, Mistry H, Stephenson M. A novel classification system for autogenous arteriovenous fistula aneurysms in renal access patients. Vasc Endovascular Surg. 48:491–496, 2014
  13. Anna Mudoni, Marina Cornacchiari, Maurizio Gallieni al.  Aneurysms and pseudoaneurysms in dialysis access,  Clinical Kidney Journal. 8(4):363–367,  2015
  14. Tordoir JH, Dammers R, van der Sande FM. Upper extremity ischemia and hemodialysis vascular access, Eur J Vasc Endovasc Surg . 27 : 1-5,2004
  15. Volker Mickley. Steal syndrome—strategies to preserve vascular access and extremity. Nephrology Dialysis Transplantation 23( 1):19–24, 2008
  16. Dodos, I., Kirmizis, I., Apostolou, C. et al. Seroma: An Underestimated Complication of Vascular Access for Haemodialysis. Hellenic Journal of Surgery . 86(5):302-306, 2014
  17. Mittal V,  Srivastava A, Kapoor R al. Management of Venous Hypertension Following Arteriovenous Fistula Creation for Hemodialysis Access. Indian Journal of Urology . 32(2): 141–148,2016
  18. Tadasi Kamata, Kojiro Yamamoto, Motohiro Okamura,  Noriyuki Iehara.An unusual case of arteriovenous fistula related venous hypertension: sonographic detection of a culprit perforating vein with movie and compact review: Renal Replacement Therapy 2:47 , 2016
  19. Lannery S, Lauvao MD, Daniel M et al.Vein diameter is the major predictor of fistula maturation: Journal of Vascular Surgery. 49(6): 1499-1504,2009.

Corresponding Author

Dr Sumanta Das

Mob: +919836230551, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.