Is ultrasound follow-up necessary in humero-axillary prosthetic arteriovenous fistulas for haemodialysis?
| Autor: | Rydings MH; Servicio de Cirugía Vascular, Hospital Clínico San Carlos, Madrid, Spain., Moñux-Ducaju G, Martínez-López I, Rial-Horcajo R, Martínez-Izquierdo A, González-Sánchez S, Serrano-Hernando FJ |
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| Jazyk: | English; Spanish; Castilian |
| Zdroj: | Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia [Nefrologia] 2012 Jul 17; Vol. 32 (4), pp. 523-8. |
| DOI: | 10.3265/Nefrologia.pre2012.Jan.11221 |
| Abstrakt: | Aim: To evaluate through a specific trial on vascular access fistulas (T-VAF), the impact of intensive follow-up controls on the permeability of humero-axillary fistulas (Hax-AVF). Patients and Method: Retrospective study. Between January 2005 and December 2009, 108 Hax-AVF were implanted. From June 2007 a T-AVF was established. A preoperative duplex was performed and a follow-up control carried out a month after the intervention and subsequently every 3 months. Results: An analysis was made of the permeability of 57 Hax-AVF carried out between June 2007 and December 2009 (T-AVF Group), in comparison to 51 interventions performed during the previous 30 months (Control Group). No differences in the permeability achieved were found at 12 and 24 months, with a secondary permeability at 12 months of 49% in the T-AVF Group and 52% in the Control Group. The percentage of patients needing to be re-operated was inferior in the T-AVF Group (35%) than in the Control Group (67%) p=0.02. The re-operation per patient average was lower in the T-AVF Group than in the Control Group (0.49 vs. 1.18 p=0.01). The patients of the TAVF Group underwent a lesser number of re-operations for obstruction as opposed to the Control Group (0.42 vs 1.04 p=0.01). Conclusions: In our experience, the intensive follow-up controls did not improve the permeability of the Hax-AVF, although re-operations due to obstruction did diminish. The follow-up of these access fistulas should be clinical based on hemodialysis data, leaving ultrasonographic evaluation for those cases where a malfunction is suspected. |
| Databáze: | MEDLINE |
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