Comparison of Side-to-side Brachiocephalic Arteriovenous fistula with Ligation of the Perforating Vein with End-to-side Brachiocephalic Arteriovenous fistula

Abstract 

Introduction

A comparison of side-to-side brachiocephalic arteriovenous fistula (BCAVF) with ligation of the perforating vein with end-to-side BCAVF.

Report

All side-to-side BCAVFs with ligation of the perforating vein and end-to-side BCAVFs that were created in two hospitals were followed up to determine complications and patency rate of arteriovenous fistulae (AVFs).

Forty-four patients (24 side-to-side BCAVFs) entered the study, but two patients were eliminated from analysis due to early mortality. Patients of both groups were free of steal syndrome and venous hypertension. There were no significant differences in maturation time and rate of complications between the two groups. Two and three failures occurred in side-to-side and end-to-side groups (P>0.05), respectively. The 1-year patency rate was 95% and 86% for side-to-side and end-to-side groups, respectively.

Discussion

Although there was no significant difference regarding primary and secondary access failure during the follow-up period, the 1-year patency rate was higher in side-to-side group, as determined by the life table analysis. In addition, there was no significant difference with regards to complications. This result may show that end-to-side BCAVF has no superiority over our new technique.

Keyword: Arteriovenous fistula, Elbow, End-to-side, Patency rate, Perforating vein, Side-to-side