ORIGINAL ARTICLE
Year : 2019  |  Volume : 6  |  Issue : 2  |  Page : 74-78

Preoperative factors predicting the outcomes of arteriovenous fistula surgery


Department of Urology and Renal Transplantation, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India

Correspondence Address:
Dr. Mallikarjuna Reddy Nalubolu
Department of Urology and Renal Transplantation, Narayana Medical College and Hospital, Nellore, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijves.ijves_87_18

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Purpose: The aim is to study the preoperative factors predicting the outcome of arteriovenous fistulas (AVF) in chronic kidney disease (CKD) patients. Successful AVF formation is vital to the success of hemodialysis treatment. The factors leading to failure of AVF maturation are still ill defined and there is a limited ability to predict surgical vascular outcomes. In part, this is due to the heterogeneity of end-stage renal disease populations. Methods: A prospective observational study was under taken on CKD patients requiring vascular access surgery for a period of 2 years were from November 2015 to October 2017. Informed consent was obtained. Demographic, clinical factors, comorbidities including age, gender, site, laterality, smoking, diabetes, hypertension, coronary artery disease and peripheral vascular disease, vessel caliber, type of anastomosis, flow across vein, and anastomosis were noted. The patient's vessel status recorded preoperatively by a Doppler ultrasound. Postoperative assessment of AVF was performed with Doppler 4 weeks after surgery. Data were analyzed to assess the risk factors predicting AVF outcomes. Results: A total of 330 cases of AV fistula were enrolled in the study. Of these 330 cases, they were categorized and evaluated separately according to the site of fistula creation. 180 underwent radio-cephalic fistulas, 100 brachio-cephalic and 50 had brachio-basilic fistulas. All the fistulas were separately categorized and evaluated for the factors predicting their outcome. Conclusions: In this study, the outflow vein diameter, arterial diameter and flow rate in the vein and across the anastomosis were the predominant factor determining the success of the proximal and distal arm fistulas.


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