Comparison of one- and two-stage basilic vein transposition for arterio-venous fistula formation in haemodialysis patients: preliminary results
| Autor: | Ali Kemal Gür, Ali Ümit Yener, Dolunay Odabaşi, Sedat Özcan |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Brachial Artery Basilic Vein Fistula arterio-venous fistula complication Veins Upper Extremity basilic vein transposition Arteriovenous Shunt Surgical Postoperative Complications Renal Dialysis medicine.artery medicine Humans Stage (cooking) Brachial artery Vascular Patency Retrospective Studies business.industry Cardiovascular Topics Ultrasonography Doppler Retrospective cohort study General Medicine Middle Aged medicine.disease Arterio-venous fistula Thrombosis Surgery Treatment Outcome Kidney Failure Chronic Ultrasonography Cardiology and Cardiovascular Medicine business |
| Zdroj: | Cardiovascular Journal of Africa |
| Popis: | Summary Objective This study aimed to compare the results of one-and two-stage basilic vein transposition (BVT) in haemodialysis patients. Methods This was a non-randomised, retrospective study between January 2007 and January 2012 on 96 patients who were diagnosed with end-stage renal failure (ESRF) (54 males, 42 females; mean age 43.6 ± 14 years) and underwent one- or two-stage BVT in our clinic. All patients who were not eligible for a native radio-cephalic or brachio-cephalic arterio-venous fistula (AVF) were scheduled for one- or two-stage BVT after arterial (brachial, radial and ulnar) and venous (basilic and cephalic) Doppler ultrasonography. Patients were retrospectively divided into two groups: group 1, basilic vein diameter > 3 mm and patients who underwent one-stage BVT; and group 2, basilic vein diameter < 3 mm and patients who underwent two-stage BVT. In group 1, the basilic vein with a single incision was anastomosed to the brachial artery, followed by superficialisation. In group 2, the basilic vein was anastomosed to the brachial artery and they underwent the superficialisation procedure one month postoperatively. Fistula maturation and postoperative complications were assessed. Results The mean diameter of the basilic vein was statistically significantly higher in group 1 (3.46 ± 0.2 mm) than in group 2 (2.79 ± 0.1 mm) (p < 0.05). In terms of postoperative complications, thrombosis, haemorrhage and haematoma were significantly higher in group 1 (34, 36 and 17%, respectively) than in group 2 (23, 14 and 6%, respectively) (p < 0.05). The rate of fistula maturation was significantly lower in group 1 (66%), compared to group 2 (77%) (p < 0.05). Time to fistula maturation was significantly shorter in group 1 (mean 41 ± 14 days), compared to group 2 (mean 64 ± 28 days) (p < 0.05). Conclusion Two-stage BVT was superior to one-stage BVT due to its lower rate of postoperative complications and higher fistula maturation, despite its disadvantage of late fistula use. Although the diameter of the basilic vein was larger in patients who underwent one-stage BVT, we observed that one-stage BVT was disadvantageous in terms of postoperative complications and fistula maturation. |
| Databáze: | OpenAIRE |
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