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- Title
A PROSPECTIVE STUDY OF COMPARISON OF DISTAL RADIOCEPHALIC FISTULA VS PROXIMAL RADIOCEPHALIC FISTULA.
- Authors
Kumar, Katti Ravi; Swamy, Kari Veerabhadra; Sarala, Mude; Motilal, Megavath
- Abstract
Introduction: The preferred type of vascular access (VA) for hemodialysis is arteriovenous fistulas. When cannulated effectively for dialysis, they have a longer lifespan and require fewer procedures than grafts. Autogenous fistulas outperform prosthetic grafts in terms of patency, infection rate, and postoperative morbidity. The aim of the present study was to evaluate the outcomes of proximal forearm AV fistula placed at elbow and distal forearm AV fistula placed at wrist. Materials and Methods: A prospective comparative study was conducted at the Department of Cardiothoracic and Vascular Surgery, Siddhartha Medical College, Vijayawada from January 2022 to December 2022. All patients who underwent hemodialysis in the medical college were included in the study. All the patients underwent pre-operative Doppler ultrasound to determine size of radial artery, size of cephalic vein, and flow rate at wrist and elbow to determine the feasibility of distal fistula or proximal fistula. Results: In proximal radiocephalic group, Mean age of the patients was 57 year ranging from 35 to 66 year. Male to female ratio was 3.12: 1. 27 patients (54%) were diabetic, 40 (80%) were hypertensive, 15 patients (30%) had cardiovascular disease. Early failure was 4 (8%) cases. Both cases were due to thrombosis. In distal radiocephalic group, Mean age of the patients was 46 year ranging from 32 year to 60 year. Male to female ratio was 3:1. 36 patients (72%) were diabetic, 26 patients (52%) hypertensive 15 (25%) had cardiovascular disease. Early failure was seen in 5 cases. Two cases were due to thrombosis and one case was due to low flow in the fistula. Conclusion: With a significantly reduced primary failure rate, higher patency rate, and lower complication rate, proximal radiocephalic fistulas (PRCF) are an appealing option to brachiocephalic fistulas in failed DRCF and patients who cannot undergo a DRCF.
- Subjects
FISTULA; ARTERIOVENOUS fistula; DOPPLER ultrasonography; RADIAL artery; LONGITUDINAL method; ARTERIAL catheterization
- Publication
Journal of Cardiovascular Disease Research (Journal of Cardiovascular Disease Research), 2023, Vol 14, Issue 6, p2331
- ISSN
0975-3583
- Publication type
Article