Fırat Üniversitesi Tıp Fakültesi Kalp Damar Cerrahisi AD, Elazığ

Background: In this study, we aimed to discuss this method by analyzing autogenous arteriovenous fistula outcomes in our experience. Methods: Outcomes of 495 autogenous arteriovenous fistulas in upper extremity in 441 hemodialysis patients due to chronic renal failure that created by authors between 1996 and 2005 were evaluated retrospectively. Nondominant upper extremity distal vessels were chosen creating arteriovenous fistula. Primary failure of vascular access and arteriovenous fistula patency rates were evaluated in early and late follow-up period. Result: Of the 441 patients, 229 (55.3%) were men and 185 (44.7%) were female. The mean age of the patients was 51.5±15.5 years. Of the 495 created autogenous arteriovenous fistula, 17 (3.4%) were in snuff-box, 368 (74.4%) were in wrist that were created by Brescia-Cimino methods between radial artery and cephalic vein, 110 (22.2%) were in antecubital space were created between brachial artery cephalic vein or bacilic vein. Early primary failure rates of created arteriovenous fistulas for snuff-box, radiocephalic and antecubital space were 17.4%, 4.1%, 1.8% respectively, whereas arteriovenous fistula patency rates were 64.8%, 80.2%, 90.9% respectively in 1 year of follow-up. Complication rate of surgical procedures was 6.7 %, and thrombosis was the most frequent complication in early period. Conclusion: We think that autogenous arteriovenous fistula should be preferred first because of it has low complication rate and prolonged vascular access in hemodialysis patients and upper extremity fistulas has acceptable outcomes.