Surgical Techniques and Results of Arteriovenous Fistulas in Chronic Renal Failure (CRF) Patients

OBJECTIVE: Arteriovenous fistulas are one of the most important routes of access for haemodialysis in chronic renal failure (CRF) patients. In this study, we aimed to discuss surgical methods and early results of arteriovenous fistulas (AVF) created for haemodialysis in CRF patients.

MATERIAL and METHOD: This study contains a total of 454 CRF patients in whom we created AVF for haemodialysis between 01 January 2007 and 23 October 2008. 271 (60%) were male and 183 (40%) female. The mean age was 53.3 (11-100) years. A radiocephalic fistula was the first choice in 279 (61.4%) patients.

FINDINGS: We performed antebrachial loop interposition with a polytetrafluoroethylene (PTFE) graft in 14 (3%) patients. We reoperated 3 of them because of graft thrombosis with the first year after graft operation. Neurological deficits occurred in one patient in this group. Despite reoperation for revascularization, she underwent amputation of the first and second fingers. Seven patients were reoperated for early dysfunction and 6 patients were reoperated because of bleeding.

RESULTS: Arteriovenous fistulas provide good confort for both patients and practitioners in connecting a dialysis machine. The upper proximal part of fistulas must be preferred before using the antecubital segment in dysfunctioning fistulas. Autologous veins must be preferred and prosthetic grafts can be used as an alternative method.