ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
The factors affecting the patency of arteriovenous fistulas formed for hemodialysis: evaluation of three-year experience
Mehmet Acıpayam, Hakan Zor, Gür Deniz Yıldız, Hasan Uncu, Mahmut Çetinoğlu, Ümit Halıcı, Levent Altınay
1Mustafa Kemal Üniversitesi Tayfur Ata Sökmen Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Hatay, Türkiye
2Gazi Üniversitesi Tıp Fakültesi, Kalp ve Damar Cerrahi Anabilim Dalı, Ankara, Türkiye
3Adana Numune Eğitim ve Araştırma Hastanesi, Seyhan Uygulama Hastanesi, Kalp ve Damar Cerrahi Kliniği, Adana, Türkiye
4Samsun Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahi Kliniği, Samsun, Türkiye
DOI : 10.5606/tgkdc.dergisi.2013.6666
Background: In this study, we assessed surgical techniques used for arteriovenous (AV) fistula formed for hemodialysis and factors affecting the fistula patency in the midterm.

Methods: Between April 2007 and July 2010, 530 patients (297 males, 233 females; mean age 57.3 years; range 18 to 86 years) who underwent AV fistula operation were retrospectively analyzed. The patients were divided into two groups including group 1 without AV fistula occlusion (n=411; mean age 57.6 years) and group 2 with AV fistula occlusion (n=119; mean age 56.0 years). Both groups were compared according to following variables: age, sex, diabetes, hypertension, coronary artery disease, cephalic vein and radial artery diameter, postoperative thrill existence on AV fistula and the rate of revision surgery.

Results: Distribution of possible risk factors within group 1 and group 2 were as follows respectively: diabetes 82 and 49 patients, hypertension 82 and 29 patients, male sex 243 and 54 patients, coronary artery disease six patients and null, small-diameter radial artery six and four patients, small-diameter cephalic vein 16 and 11 patients, revision surgery eight and five patients, palpable postoperative thrill 377 and 100 patients. We found significant differences in the factors including sex, diabetes, cephalic vein radius and postoperative thrill between the groups (p=0.008, p=0.000, p= 0.0019, p=0.0014, respectively).

Conclusion: In patients with chronic renal failure, diabetes, female gender and cephalic vein diameter of <2 mm affect the patency of AV fistula adversely, while postoperative trill and male gender affect the patency of AV fistula positively.

Keywords : Arteriovenous fistula; basilic vein transposition; chronic renal failure; Cimino-Brescia; fistula patency; snuff-box
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