Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Clinical Analysis of Radiocephalic Fistula Using Side-to-side Anastomosis with Distal Cephalic Vein Ligation

  • Hong, Sung Yong (Department of Thoracic and Cardiovascular Surgery, Busan Paik Hospital, Inje University College of Medicine) ;
  • Yoon, Young Chul (Department of Thoracic and Cardiovascular Surgery, Busan Paik Hospital, Inje University College of Medicine) ;
  • Cho, Kwang-Hyun (Department of Thoracic and Cardiovascular Surgery, Busan Paik Hospital, Inje University College of Medicine) ;
  • Lee, Yang-Haeng (Department of Thoracic and Cardiovascular Surgery, Busan Paik Hospital, Inje University College of Medicine) ;
  • Han, Il-Yong (Department of Thoracic and Cardiovascular Surgery, Busan Paik Hospital, Inje University College of Medicine) ;
  • Park, Kyung Taek (Department of Thoracic and Cardiovascular Surgery, Busan Paik Hospital, Inje University College of Medicine) ;
  • Ko, Seong-Min (Department of Thoracic and Cardiovascular Surgery, Busan Paik Hospital, Inje University College of Medicine)
  • Received : 2013.03.19
  • Accepted : 2013.07.15
  • Published : 2013.12.05
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Abstract

Background: 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 procedures in the ligation and division of a distal vein to achieve similar effects as those of vein end-to-arterial side after side-to-side anastomosis. Methods: We retrospectively reviewed the clinical data of 113 patients who came for an outpatient clinic follow-up to the department of internal medicine of our hospital; these patients were among the 125 patients who underwent radiocephalic arteriovenous fistula (side-to-side anastomosis with distal vein ligation and division) in our hospital in the period from January 2006 to December 2010. Results: The patency rate showed no statistical significance with respect to sex (p=0.775), age (p=0.775), hypertension (p=0.262), diabetes (p=0.929), and cardio-neurovascular disease (p=0.717). Patency rates were 96% for the first month, 93% for the first year, and 90% for the second year for the radiocephalic arteriovenous fistula (side-to-side anastomosis with distal vein ligation and division) performed on the wrist. Conclusion: The patency rates revealed favorable results and few postoperative complications as compared to those of previous reports. Therefore, radiocephalic fistula using side-to-side anastomosis with distal cephalic vein ligation is considered a recommendable surgical procedure in the distal part for the hemodialysis of CRF patients.

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References

  1. Vascular Access 2006 Work Group. Clinical practice guidelines for vascular access. Am J Kidney Dis 2006;48 Suppl 1:S176-247. https://doi.org/10.1053/j.ajkd.2006.04.029
  2. Ahsan ZU, Waheed A, Zaeem FA, Nazir F. Arteriovenous fistulas constructed using side-to-side anastomosis with ligation and division of distal venous arm: a tertiary care hospital experience. J Vasc Access 2010;11:26-30.
  3. Bennion RS. Autogenous arteriovenous fistula. In: Strandness DE, Breda AV, editors. Vascular diseases: surgical and interventional therapy. New York: Churchill Livingstone; 1994. p. 1048.
  4. Chung KY, Kim YS, Cho HR, et al. The importances of size or status of cephalic vein during formation of internal vascular access. J Korean Surg Soc 1993;44:273-8.
  5. Seong SW, Song MH, Sung GY, et al. Clinical analysis of anatomical snuffbox arteriovenous fistula. J Korean Vasc Surg Soc 1998;14:316-20.
  6. Cho LH, Yu HC, Jung SH, Cho BH. Clinical experience with internal arteriovenous fistula formation. J Korean Vasc Surg Soc 1998;14:321-9.
  7. Cho HG, Moon IS, Park JS, Koh YB. Clinical experience of AV fistula hemodialysis of chronic renal failure patients. Korean J Vasc Endovasc Surg 1995;12:121-7.
  8. Kolff WJ, Berk HT, Welle NM, van der Ley AJ, van Dijk EC, van Noordwijk J. The artificial kidney: a dialyser with a great area. Acta Med Scand 1944;117:121-34.
  9. Quinton W, Dillard D, Scribner BH. Cannulation of blood vessels for prolonged hemodialysis. Trans Am Soc Artif Intern Organs 1960;6:104-13.
  10. Brescia MJ, Cimino JE, Appel K, Hurwich BJ. Chronic hemodialysis using venipuncture and a surgically created arteriovenous fistula. N Engl J Med 1966;275:1089-92. https://doi.org/10.1056/NEJM196611172752002
  11. Cascaro S, Acchiardo S, Beven EG, Popowniak KL, Nakamoto S. Proximal arteriovenous fistulae for haemodialysis when radial arteries are unavailabe. Proc Europ Dial Transplant Assoc 1970;7:42-6.
  12. Gracz KC, Ing TS, Soung LS, Armbruster KF, Seim SK, Merkel FK. Proximal forearm fistula for maintenance hemodialysis. Kidney Int 1977;11:71-5. https://doi.org/10.1038/ki.1977.9
  13. Mehigan JT, McAlexander RA. Snuffbox arteriovenous fistula for hemodialysis. Am J Surg 1982;143:252-3. https://doi.org/10.1016/0002-9610(82)90080-0
  14. Marx AB, Landmann J, Harder FH. Surgery for vascular access. Curr Probl Surg 1990;27:1-48.
  15. Wong V, Ward R, Taylor J, Selvakumar S, How TV, Bakran A. Factors associated with early failure of arteriovenous fistulae for haemodialysis access. Eur J Vasc Endovasc Surg 1996;12:207-13. https://doi.org/10.1016/S1078-5884(96)80108-0
  16. Tonelli M, Hirsch DJ, Chan CT, et al. Factors associated with access blood flow in native vessel arteriovenous fistulae. Nephrol Dial Transplant 2004;19:2559-63. https://doi.org/10.1093/ndt/gfh406
  17. Reilly DT, Wood RF, Bell PR. Prospective study of dialysis fistulas: problem patients and their treatment. Br J Surg 1982;69:549-53. https://doi.org/10.1002/bjs.1800690918
  18. Palder SB, Kirkman RL, Whittemore AD, Hakim RM, Lazarus JM, Tilney NL. Vascular access for hemodialysis. Patency rates and results of revision. Ann Surg 1985;202: 235-9. https://doi.org/10.1097/00000658-198508000-00015
  19. Jang JY, Hwang BK, Ha WS, et al. A clinical study for the factors influencing early patency of internal arteriovenous fistula in chronic renal failure patients. J Korean Surg Soc 1991;41:635-40.
  20. Lauvao LS, Ihnat DM, Goshima KR, Chavez L, Gruessner AC, Mills JL Sr. Vein diameter is the major predictor of fistula maturation. J Vasc Surg 2009;49:1499-504. https://doi.org/10.1016/j.jvs.2009.02.018

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