Document Detail


Creation of permanent hemodialysis vascular access in patients with failed arteriovenous fistula.
MedLine Citation:
PMID:  17268698     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the patency rate and complications of arteriovenous fistula (AVF) with synthetic graft in patients with previous history of failed AVF. METHODS: This study was carried out at Sina Hospital, Tehran, Iran from April 2002 to July 2003. Patients who had been referred to our center with previous failed attempt for creation of AVF were collected. We again tried to create an AVF in some of these patients according to physical examination and clinical judgment of the vascular surgeon. A synthetic graft was inserted for the remainder of the patients. All patients were followed up for 3 months. RESULTS: Elbow fistula placement was possible in 43% of patients including half of patients with diabetes and half of those more than 65 years old. Failure occurred in 33% of grafts versus 19% of fistulas. The complications were venous hypertension in one case and infection in 2 cases, all from the graft group. CONCLUSION: Our results show lower failure, mortality, and complication in AVFs than the synthetic graft, similar to previous reports. However, there were some limitations such as small sample of patients and short duration of follow up in our study. We suggest that AVF is an option even in patients who had previous multiple procedures with the advantage of being cost-effective, and with fewer complications. However, we cannot conclude any superiority for one method, as it is not a properly designed comparative trial.
Authors:
Majid Moini; Mohammad R Rasouli; Hussein Rayatzadeh
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Saudi medical journal     Volume:  28     ISSN:  0379-5284     ISO Abbreviation:  Saudi Med J     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-02-01     Completed Date:  2007-09-11     Revised Date:  2008-06-23    
Medline Journal Info:
Nlm Unique ID:  7909441     Medline TA:  Saudi Med J     Country:  Saudi Arabia    
Other Details:
Languages:  eng     Pagination:  213-5     Citation Subset:  IM    
Affiliation:
Division of Vascular Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. moinim@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Arteriovenous Shunt, Surgical / adverse effects*,  methods
Catheters, Indwelling*
Cohort Studies
Diabetic Nephropathies / complications
Disease Progression
Female
Follow-Up Studies
Humans
Kidney Failure, Chronic / etiology,  physiopathology,  therapy*
Male
Middle Aged
Probability
Renal Dialysis / adverse effects,  methods*
Risk Assessment
Time Factors
Treatment Outcome
Vascular Patency

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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