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ePublished: 06 Aug 2017
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J Renal Inj Prev. 2017;6(4): 282-285.
doi: 10.15171/jrip.2017.53

Scopus ID: 85040725283
  Abstract View: 1957
  PDF Download: 1214

Original Article

Antecubital arteriovenous fistula in hemodialysis; a comparison between side-to-side versus end-to-side venous anastomosis

Iraj Nazari 1, Seyed Mansour Alamshah 1, Mohammad Bahadoram 2, Nozar Dorestan 1 *

1 Department of Vascular Surgery, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
2 Medical Students Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
*Corresponding author: Nozar Dorestan, dorestan.n@ajums.ac.ir

Abstract

Introduction: Chronic Kidney Disease (CKD) is a global health problem which is growing in prevalence. Hemodialysis is the most common treatment for end-stage renal disease (ESRD) which requires a permanent vascular access. Vascular accesses should have a good patency and low complication.

Objectives: The present study aimed to compare side-to-side (STS) versus end-to-side (ETS) methods in antecubital arteriovenous fistulas in dialysis patients. Patients and Methods: In this randomized, single-blind clinical trial, 100 ESRD patients who scheduled for hemodialysis were divided into two groups. STS arteriovenous anastomosis was employed in one group and in the other, the ETS approach was conducted. Follow ups were done after 1, 8, and 24 weeks to detect fistula maturation and immediate or delayed complications.

Results: The STS anastomosis group demonstrated higher rates of delayed maturation, vascular aneurism, and venous hypertension syndrome than ETS anastomosis group. The ETS group, however, showed higher rates of venous thrombosis and vascular stenosis. Overall, the rate of complications was 24% and 8% for STS and ETS anastomosis group respectively (P =0.03).

Conclusion: In comparison, ETS arteriovenous fistulas involve less complications than STS method in ESRD patients. However, more thrombosis and stenosis detected by ETS method. ETS arteriovenous fistulas had less delayed maturation, aneurism, venous hypertension and overall complications than STS approach. ETS arteriovenous fistulas contributes to establishing a more stable connection to hemodialysis machine to conduct a more effective hemodialysis.

Keywords: Hemodialysis, Anastomosis, Arteriovenous fistula, Chronic kidney disease, End-stage renal disease

Implication for health policy/practice/research/medical education:

In a study on 100 end-stage renal disease, we found ETS arteriovenous fistulas had less complications compared to the STS technique in this patients.

Please cite this paper as: Nazari I, Alamshah SM, Bahadoram M, Dorestan N. Antecubital arteriovenous fistula in hemodialysis; a comparison between side‐to‐side versus end‐to‐side venous anastomosis. J Renal Inj Prev. 2017;6(4):282-285. DOI: 10.15171/jrip.2017.53.

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Abstract View: 1957

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PDF Download: 1214

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