• J. Am. Coll. Surg. · Jul 2009

    Secondary autogenous arteriovenous fistulas in the "fistula first" era: results of a longterm prospective study.

    • Loay Salman, Manju Alex, Stephen W Unger, Gabriel Contreras, Oliver Lenz, and Arif Asif.
    • University of Miami Miller School of Medicine, Interventional Nephrology, Miami, FL 33136, USA.
    • J. Am. Coll. Surg. 2009 Jul 1; 209 (1): 100-5.

    BackgroundThe outflow vein of a dysfunctional arteriovenous dialysis access can be used to create a secondary autogenous arteriovenous fistula (SAVF) (type I). In the absence of an outflow vein, an SAVF can still be created elsewhere in the ipsilateral or contralateral extremity by identifying vessels suitable for SAVF creation (type II). But their patency rates and the use of tunneled dialysis catheters during the postoperative period have not been reported in a prospective fashion.Study DesignPatients undergoing SAVF creation were included in this analysis. Data were collected prospectively. The primary, secondary, and cumulative patency rates, along with the number of procedures required to maintain patency, were investigated. The need for tunneled dialysis catheters in patients with SAVF before the fistula was ready to support dialysis was also evaluated.ResultsSixty-two (type I, n=35; type II, n=27) SAVFs were created over a period of 5 years. The primary patency rates for types I and II SAVF at 6 and 12 months were 87% and 14% (type I) and 71% and 11% (type II), respectively. The secondary patency rates for type I at 12, 24, and 36 months were 100%, 100%, 83%, respectively, and for type II were 92%, 88%, 83%, respectively. The primary and secondary patency rates between the groups were not statistically significant. The cumulative patency rates for type I at 12, 24, and 36 months were 100%, 100%, 94%, respectively, and for type II were 96%, 96%, and 91%, respectively. Type I required 1.4 procedures/year, and type II needed 1.5 procedures/year (p=nonsignificant). Tunneled dialysis catheters were required in 21 patients with type I and 27 patients with type II SAVF.ConclusionsAlthough the primary patency rates were not colossal, excellent secondary and cumulative patency rates were observed for SAVF in this study.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…