Surgical interventions for autogenous arteriovenous fistula aneurysms in hemodialysis patients

Year 2018, Volume: 4 Issue: 3, 180 - 186, 04.07.2018

Kadir Kaan Özsin , Umut Serhat Sanrı , Nail Kahraman , Faruk Toktaş , Şenol Yavuz

https://doi.org/10.18621/eurj.422085

Abstract

Objectives. The aim of this study was to emphasize the importance
of surgical intervention perfotmed before development of arteriovenous fistula (AVF)
aneurysm complications. Methods. The patients were categorized
 into two groups: Patients undergoing elective
surgery for autogenous AVF aneurysm were defined as elective group (Group 1), whereas
those who underwent emergency surgery due to ruptured aneurysmal fistulas were
defined as emergency group (Group 2). All elective cases were evaluated by
doppler ultrasonography before surgery. All patients had temporary hemodialysis
catheters. In the patients with salvaged fistulas, the fistulas was rested for
1 week. A new fistula was created in patients with not salvaged fistula. Results. A total of 31 patients (54.8% male, mean age: 41.2 ± 14.7 years) were in
Group 1 and 7 patients (57.1% male, mean age: 53 ± 9.4 years) were in Group 2. Significant
difference was observed between two groups in terms of fistula preservation.
Salvaged fistulas were significantly higher in the Group 1 than Group 2 (p = 0.003). In Kaplan-Meier curves,
cumulative primary AVF patency rates at 1, 3 and 6 months were 96.3%, 81.5%,
and 77.8% in Group 1 and 66.7%, 66.7%, and 66.7% in Group 2, respectively (log-rank;
p = 0.536). Conclusions. Consultation
of these cases with a cardiovascular surgeon before they reach the rupture
stage is an important condition for both the patency of the fistula and the
vital risk of the patient. 

Keywords

Arteriovenous fistula aneurysms, salvage treatment, hemodialysis

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