VS16P OUTCOMES OF ARTERIOVENOUS FISTULA FOR VASCULAR ACCESS

Abstract

Introduction Vascular access for chronic haemodialysis persists as a surgical challenge. The development of the radiocephalic arteio venous fistula in 1966 by Brescia was a milestone in vascular access surgery. There has been a move away from the use of prosthetic due to the associated complications.A decision was made at this institution to use autologous vein in all cases recognising the consequence of using marginal veins.Aim To determine the Outcomes of all Radiocephalic, Bracheocephalic and Transposition arterio venous fistulae.Method A retrospective study by review of the case notes was carried out in March 2006.All renal access procedures performed between 6/03 and 6/05 were reviewed.In the new native fistulas formed during this time, the following end points were sought: Primary, secondary and functional patency at 24 hrs. 6 weeks, 6 months and 1 year.Results Life table analysis of the patency outcomes showed that Percentage primary patency rates for Radiocephalic and Bracheocephalic fistulae were 71% and 74% at 1 year respectively. Subgroup analysis of females, diabetics and those with BMI > 30 showed diabetics composed >40% of patients and patients with BMI >30 was 29%. Of these two subgroups primary patency rates were comparable to the whole group.Conclusion The population studied was different to those in other parts of the world. FavourablePrimary patency rates were obtained for this challenging group of patients.