COMPARATIVE STUDY OF THE CLINICAL OUTCOMES OF FUNCTIONAL SIDE TO SIDE ANASTOMOSIS AND TRADITIONAL END TO SIDE ANASTOMOSIS IN RADIO CEPHALIC FISTULA FOR DIALYSIS ACCESS

Abstract

Background : End stage renal disease is a major public health problem, incidence of which is increasing every year. The signicant mortality and morbidity associated with end stage renal disease is directly related to vascular access for hemodialysis. Hence, in this study we attempt to compare the outcomes of functional side to side anastomosis and traditional end to side anastomosis in radio cephalic AVF. Methods : Totally 60 patients with CKD receiving radial artery-cephalic vein arteriovenous shunt for hemodialysis were randomly divided into 2 groups, namely, the functional side-side anastomosis and the traditional end-side anastomosis. All parameters related to success rate and patency rate of the two methods were compared and analyzed. Comparative analysis of mean Results : cephalic vein diameter at 2nd and 6th week between ETS and STS groups showed statistically signicant difference(p value <0.0001). But, at 12th week, mean diameter was not statistically signicant. Flow rate across anastomosis in both groups were kept on increasing, but was less in STS than ETS. The short-term patency rates are similar between haemodialysis patients undergoing functional and traditional end-to-side anastomosis for radial artery-cephalic vein arteriovenous stula. Although not all Conclusion : the results of the study were statistically conclusive but the parameters of Flow rate across anastomosis and cephalic vein diameter across anastomosis in the Functional STS group show statistically signicant results thus fullling two important criteria for stula maturation in accordance with ― The Rule of Sixe. The Functional side-to-side technique can be denitely applied for initiating renal replacement therapy with some advantages over end-to-side technique, and without increasing the risk of primary failure of the stula