An Experience in Arterio-Venous Fistula creation for Chronic Haemodialysis

Abstract

Obtaining a vascular access for haemodialysis is very vital in the long-term management of patients with end-age renal disease. This is achieved via an autogenous (primary) arteriovenous fistula or a grafted fistula in situations where autogenous fistulas may not function.
Complications such as thrombosis and infection are common following graft creation, and they contribute significantly to the cost of dialysis therapy. In a prospective study of the patients who underwent Anterior-venous fistula creation by our team in Lagos, Nigeria from 1995 to December 2002, a protocol was designed and data were collected.
The data included their ages, gender, the indications, site and types of fistulae created. We constructed 32 fistulae within the period-21 males and 11 females giving a M:F of 2:1. Brescia cimino fistulae were created 25 (81.3%) of the patients. Polytetrafluorothylene graft fistulae were created in 7(21.95) of the patients.
The only indication for surgery was the need for access for haemodialysis in end stage renal disease. Three of the fistulae got thrombosed acutely while others did well. The study aimed at highlighting the surgical methods of vascular access and the possible complications in our environment.
We concluded that radio-cephalic arterio-venous fistula provides the best vascular access for chronic haemodialysis


NQJHM Vol. 13 (3-4) 2003: pp. 54-55