Arteriovenous fistula: end-to-end or end-to side anastomosis?
Summary of "Arteriovenous fistula: end-to-end or end-to side anastomosis?"
The purpose of the present study was to compare the end-to-end (ETEa) with the end-to-side (ETSa) anastomosis in patients starting hemodialysis by means of radio-cephalic artero-venous fistulae (AVF). In our experience, we compared the results, as early failure (EF), late thrombosis (LT), stenosis, steal syndrome, and primary patency (PP), in 2 groups of hemodialysis incident patients that had been placed an AVF by means of ETEa or ETSa. The observation period lasted 24 months for each of the 2 types of AVF, starting from October 2005 to September 2007 for ETEa and from October 2007 to September 2009 for ETSa. One hundred forty patients were included in the present study. We have consecutively performed 99 AVF interventions at the wrist or at the third distal of the forearm, in 70 patients by means of ETEa and 82 AVF interventions in the same anatomical places in 70 patients by means of ETSa. The patients with ETEa had a mean age of 64.4 ± 14.6 years, males were 65.8% and the age dialysis at the end of observation was 10.4 ± 5.7 months. Those with ETSa had a mean age of 65.9 ± 15.5 years and the males were 62.9%, the age dialysis at the end of observation was 9.2 ± 5.5 months. The surgical team was composed by the same nephrologists. The statistical study was performed by means of the χ chi-square and Fisher's exact test. We have observed more late thrombosis (10% vs. 4.1%) and stenosis (21.4% vs. 2.7%) in ETEa than in ETSa. The number of early thrombosis was similar in the 2 types of anastomosis. The primary patency 1-year rate was better though not significantly in the ETS (80% vs. 85.7%) In our experience the ETSa provides, overall better results, both regarding the complications and primary survival than ETEa. For the benefits that seem to come from it, we believe, that a broad ETSa in the distal native AVF is preferable to the ETEa.
Nephrology and Dialysis Unit, Spirito Santo Hospital, Pescara, Italy.
This article was published in the following journal.
Name: Hemodialysis international. International Symposium on Home Hemodialysis
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21083870
- DOI: http://dx.doi.org/10.1111/j.1542-4758.2010.00503.x
The surgically created arteriovenous fistula has recently been recommended as the best available angioaccess for hemodialysis. Therefore, in this study, we carried out a clinical analysis on surgical...
Objective: To evaluate the two year patency rate of functioning arteriovenous fistula. Methodology: This prospective case series study was conducted at Department of Urology, Jinnah Postgraduate Medic...
Traumatic renal arteriovenous fistula involving the inferior vena cava (IVC) are exceptionally rare, but if left untreated can have devastating clinical consequences, including development of renovasc...
An internal permanent vascular access [arteriovenous fistula (AVF) or arteriovenous graft (AVG)] is preferred over central venous catheters (CVC) for chronic hemodialysis. However, CVC remain the most...
Although a certain degree of arteriovenous shunting may be expected in glioblastoma, to our knowledge, the coexistence of a glioblastoma and arteriovenous fistula has not been previously reported. In...
This project will bank sera, DNA and vascular specimens from patients undergoing arteriovenous fistula creation and revision
The primary objective is to determine if the use of losartan, an angiotensin II receptor blocker, can attenuate left ventricular hypertrophy, independent of its antihypertensive effects, i...
The primary objective of this study is to compare two treatment strategies for establishing dialysis access in patients with unsuitable forearm veins for the standard forearm primary radio...
The requirements for haemodialysis are increasing. There is now acceptance that the most durable AV fistulae are those created from the patients own veins. Use of the radiocephalic arterio...
The objective of this study was to compare the functional and surgical results of the J-pouch with those of the side-to-end anastomosis and their impact on quality of life.
Medical and Biotech [MESH] Definitions
A vessel that directly interconnects an artery and a vein, and that acts as a shunt to bypass the capillary bed. Not to be confused with surgical anastomosis, nor with arteriovenous fistula.
An abnormal direct communication between an artery and a vein without passing through the CAPILLARIES. An A-V fistula usually leads to the formation of a dilated sac-like connection, arteriovenous aneurysm. The locations and size of the shunts determine the degree of effects on the cardiovascular functions such as BLOOD PRESSURE and HEART RATE.
Surgical union or shunt between ducts, tubes or vessels. It may be end-to-end, end-to-side, side-to-end, or side-to-side.
Abnormal formation of blood vessels that shunt arterial blood directly into veins without passing through the CAPILLARIES. They usually are crooked, dilated, and with thick vessel walls. A common type is the congenital arteriovenous fistula. The lack of blood flow and oxygen in the capillaries can lead to tissue damage in the affected areas.
An abnormal anatomical passage between the INTESTINE, and another segment of the intestine or other organs. External intestinal fistula is connected to the SKIN (enterocutaneous fistula). Internal intestinal fistula can be connected to a number of organs, such as STOMACH (gastrocolic fistula), the BILIARY TRACT (cholecystoduodenal fistula), or the URINARY BLADDER of the URINARY TRACT (colovesical fistula). Risk factors include inflammatory processes, cancer, radiation treatment, and surgical misadventures (MEDICAL ERRORS).