The Brachiobasilic Arteriovenous Fistula: Effect of Patient Variables
| Autor: | Melanie Field, David Mak, Steve Mellor, Nick Inston, Hannah Winter, David Van Dellen, Ahmed Hamsho |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent Brachial Artery medicine.medical_treatment Fistula Population Arteriovenous fistula Kaplan-Meier Estimate Single Center Risk Assessment Veins Upper Extremity Young Adult Arteriovenous Shunt Surgical Renal Dialysis Risk Factors medicine Humans education Vascular Patency Dialysis Aged Aged 80 and over Peripheral Vascular Diseases education.field_of_study Vascular disease business.industry Patient Selection Age Factors Middle Aged medicine.disease Surgery Transplantation Treatment Outcome England Nephrology Female Hemodialysis business |
| Zdroj: | The Journal of Vascular Access. 12:325-330 |
| ISSN: | 1724-6032 1129-7298 |
| DOI: | 10.5301/jva.2011.8349 |
| Popis: | Purpose The hemodialysis population is constantly expanding as patients on dialysis have increased longevity and the number of kidneys available for transplantation remains static (1). After radiocephalic and brachiocephalic fistulas have been exhausted the use of the autologous brachiobasilic fistula (BBAVF) should be considered prior to use of a synthetic graft. We present our single center experience of 140 brachiobasilic fistulas in a five-year period and examine any factors that influence patency and long-term function. Methods Patients who had undergone formation of a BBAVF between January 2004 and January 2009 were identified; a review of all case notes and databases was undertaken. Details on demographics, cause of renal failure, co-morbidities (including diabetes, cardiac morbidity, hypertension, peripheral vascular disease), dialysis status at the time of fistula creation, hemoglobin, anti-coagulation regimens, and complications from surgery were recorded. Results Patency (defined as use of AVF for dialysis) was 83% at 3 months, 77% at 6 months, and 69% at 12 months. Length of patency ranged from 0 to 1918 days (at study cut-off) with a mean patency of 532 days. Factors found to significantly affect fistula patency included age over 60 ( P=Conclusions Our brachiobasilic fistula patency rates are comparable with published literature and other fistulas. Within our population patient variables including age over 60 and the presence of peripheral vascular disease are associated with worse outcomes as would be expected. In spite of these factors we feel the brachiobasilic fistula is an excellent option for patients with more challenging access and should certainly be undertaken prior to the use of prosthetic grafts. |
| Databáze: | OpenAIRE |
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