Factors Affecting the Patency of Arterio Venous Fistula for Dialysis Access

  • Deepak Thapa Magar National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
  • Kiran Shrestha National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
  • Dinesh Chapagain National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
  • Kumar Shrestha National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
  • Sara Thapa Chitwan Medical College, Chitwan.
Keywords: Arteriovenous fistula, End stage renal disease, Hemodialysis, Patency.

Abstract

Introduction : End-stage renal disease is a chronic disease requiring treatment with dialysis
or renal transplantation. Autologous arteriovenous fistula is the gold standard for vascular
access for hemodialysis .The aim of this study is to determine the different factors which
play the role for the patency of autologous arteriovenous fistula.

Method: This is the hospital based prospective study, conducted for the period of 12 months
from September 2017 to September 2018 in department of CardioThoracic and Vascular
Surgery of Bir Hospital. Autologous vein were used to creat radio cephalic (Brescio-Cimino)
or brachio cephalic fistula. Different factors age, sex, size of the vessels, site of the
anastomosis, comorbid diabetes Mellitus were taken into consideration.

Results: The total number of patients included in this study was 304. Radio cephalic fistula
was made in 175 (57.56 %) while brachiocephalic fistula was made in 129 (42.43%),
patients. Overall patency rate was 85.85%.We had a most common complication bleeding,
thrombosis 30 (9.86%), upper limb edema 26 (8.55%) and infection 19 (6.25%).
Conclusion: Autologous arteriovenous fistula is the better choice for vascular access for
hemodialysis in patients with end-stage renal disease. Different factors like site of the anastomosis, female gender, diabetes mellitus and most importantly size of the vessels play
an important role in the patency of arterio venous fistula.

Author Biographies

Deepak Thapa Magar, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal

Chief Consultant Surgeon, CTVS unit, Department of surgery

Kiran Shrestha, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal

Cardio thoracis and vascular surgery unit, Department of surgery

Dinesh Chapagain, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal

Cardio thoracis and vascular surgery unit, Department of surgery

Kumar Shrestha, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal

Cardio thoracis and vascular surgery unit, Department of surgery

Published
2020-02-11