Document Detail


Comparison of radiocephalic fistulas placed in the proximal forearm and in the wrist.
MedLine Citation:
PMID:  20723157     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Non-maturation is a common problem in patients receiving an arteriovenous fistula. The first vascular access choice is a distal radiocephalic fistula (dRCF) at the wrist. Patients with a failed dRCF or with vessels unsuitable for dRCF, the recommendation is to place a brachiocephalic fistula in the upper arm. Proximal forearm radiocephalic fistulas (pRCF) are created infrequently, but may permit a second forearm fistula before proceeding to the upper arm. The goal of the present study was to compare the outcomes of them. We retrospectively analyzed a computerized access database to compare the outcomes of 19 RCF and 39 dRCF placed during a 6-month period. The baseline characteristics were similar, except those with a pRCF were more likely to have previous access and be male. Primary failure (non-maturation) was lower for pRCF than dRCF (32 vs. 59%, p = 0.05); and excluding secondary failures, cumulative fistula survival was similar (92 vs. 86% at 1 year and 74 vs. 76% at 2 years, p = 0.56). pRCF may be an attractive alternative to a brachiocephalic fistula in patients who cannot receive a dRCF. pRCF has a lower non-maturation rate than that of a dRCF, and a comparable cumulative survival once it is used successfully for dialysis.
Authors:
Rajeshkumar Bhalodia; Michael Allon; Alan M Hawxby; Ivan D Maya
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-08-13
Journal Detail:
Title:  Seminars in dialysis     Volume:  24     ISSN:  1525-139X     ISO Abbreviation:  Semin Dial     Publication Date:    2011 May-Jun
Date Detail:
Created Date:  2011-06-20     Completed Date:  2011-11-03     Revised Date:  2014-05-23    
Medline Journal Info:
Nlm Unique ID:  8911629     Medline TA:  Semin Dial     Country:  United States    
Other Details:
Languages:  eng     Pagination:  355-7     Citation Subset:  IM    
Copyright Information:
© 2010 Wiley Periodicals, Inc.
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MeSH Terms
Descriptor/Qualifier:
Arteriovenous Shunt, Surgical / methods*
Brachiocephalic Veins / surgery*
Female
Forearm / blood supply
Humans
Male
Middle Aged
Radial Artery / surgery*
Renal Dialysis
Retrospective Studies
Wrist / blood supply
Grant Support
ID/Acronym/Agency:
K24 DK059818/DK/NIDDK NIH HHS; R01 DK085027/DK/NIDDK NIH HHS
Comments/Corrections

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