COMPARATIVE STUDY BETWEEN ONE-STAGE AND TWO- STAGE BRACHIO BASILIC ARTERIOVENOUS FISTULA AS A HEMODIALYSIS ACCESS PROCEDURE

Abstract

Background: The primary use of autogenous arteriovenous access for chronic hemodialysis is recommended by the National Kidney Foundation–Dialysis Outcomes Quality Initiative practice guidelines. Brachiaobasilic (BB) fistulae are a form of vascular access for patients requiring dialysis. Brachiaobasilic (BB) fistulae can be created with either a single stage or a two stage procedure. Objective: The goal of this study was to compare the failure rates and functional patencies of one-stage vs two-stages brachiobasilic fistulas. Patients and Methods: Fifty patients with chronic renal failure (CRF) with the cephalic vein was unsuitable for use or failed brachio cephalic were admitted to The Vascular Surgery Unit in Al-Hussein University Hospital in the period from Jun. 2011 to Jun 2013.One stage procedure was done to twenty five patients of them and two stages procedure was done to the rest of the patients. Results: Two stages procedure failure rates were lower than one stage procedure. Two stage procedure survived longer than one stage procedure. There was no difference in primary failure between the two groups which were due to hypotension, thrombosis of vein , and small sized basilic vein. Two cases of wound infection had occurred in obese and diabetic patients which was controlled by drainage and umbrella of antibiotics. Conclusion: Two stage procedure BB fistulae was better than one stage procedure in primary patency and access survival.