Retrospective Study of Autologous Arteriovenous Fistula Creation as Vascular Access for Hemodialysis

Abstract

IntroductionAn autologous arteriovenous fistula (AVF) creation is a common vascular procedure forhemodialysis (HD) patients. This surgical procedure aim is to design a vascular conduct thatwithstands hemodialysis for a durable period. However, the functional outcome of this procedurevaries and depends on patients’ various predictors. .MethodsA retrospective observational study was carried out to evaluate the functional outcome of AVFcreation at the cardiothoracic vascular surgery unit of the surgery department of B.P KoiralaInstitute of Health Sciences from February 2019 to February 2020. The medical file of the patientswas studied, relevant data entered and analyzed in SPSS statistical software.ResultsThere were a total of 112 autologous AVF created during the study period. The mean age ofthe patients was 48.66±15.64 years. There were 75(67%) males and 37(33%) females. The mostcommon limb of fistula creation was left non-dominant upper limb 95(84.8%) and right upper limb17(15.2%). The most common type of AVF was radiocephalic fistula 66(58.9%) and brachiocephalicfistula 46(41.1%). There were 92(82.1%) mature fistula at eight weeks follow-up. These include54(48.2%) radiocephalic fistulas and 38(33.9%) brachiocephalic fistulas. There were 20(17.8%)delayed matured fistulas at 12 weeks (12 radiocephalic and 8 brachiocephalic AVF).ConclusionsThe creation of an autologous AVF for hemodialysis in the upper limb has fewer complications andthe maturation of the AVF depends on the vessel’s diameter. Radio-cephalic and BrachiocephalicAVF usually matures between six to eight weeks duration