ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Dündar Özalp Karabay, *Ufuk Yetkin, **Hakan Önol
Dokuz Eylül Üniversitesi Tıp Fakültesi, Kalp Damar Cerrahisi Ana Bilim Dalı, İzmir
*Atatürk Eğitim ve Araştırma Hastanesi, Kalp Damar Cerrahisi Kliniği, İzmir
**Alsancak Devlet Hastanesi, Kalp Damar Cerrahisi Kliniği, İzmir
Background: The surgical technique, our patency rates, complications, experiences and results of arteriovenous fistulas for vascular access of hemodialysis patients were presented.

Methods: Between January 1997 and December 2002 arteriovenous fistula operations in 486 chronic renal failure cases for vascular access were investigated prospectively. Non-dominant arm was chosen for the operation. In 94 cases a reoperation was applied due to thrombosis and failure to be matureted. In 24 cases a third operation was performed at the brachial level due to nonfunctioning former fistulas.

Results: Of the 486 cases, 293 cases were male (60%) and 193 cases were female (40%).The mean age was 47.3 ± 5.3 years. Following the first operation, the patency of fistula was obtained in 392 cases. In 94 cases, whose fistulas did not function initially, 40 (42%) patients were reoperated at the brachial artery level, whereas the remaining 54 (58%) underwent the Brescia-Cimino type fistula operation on contralateral arm. Twenty one cases needed a third operation at the brachial artery level using autogenous artery and vein due to failure of the second fistula. In 486 cases, 601 operations were performed totally without using a synthetic graft material and additional surgical intervention at the femoral artery level, by reaching functioning fistulas finally.

Conclusions: While performing vascular access surgery, functioning of anastomosis, avoiding from complications and a long-term use of fistula are aimed. The Brescia-Cimino type distal arteriovenous fistula (AVF) should be performed as the first choice for vascular access.

Keywords : Chronic renal failure, hemodialysis, arteriovenous fistula
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