Arteriovenöz fistüllerde açık kalma oranları

Bu çalışmanın amacı kronik böbrek yetmezlikli (KBY) hastalarda açılan arteriovenöz (A-V) fistüllerin, cinsiyet de gözetilerek, erken ve geç dönemde açık kalma oranlarını ortaya koymaktır. Hemodializ amacıyla oluşturulan A-V fistüller retrospektif olarak incelendi. 238 olgunun 130'u erkek hastaydı. ikiyüzotuzsekiz hastaya toplam 269 operasyon yapıldı. 198 (%73.6)'i radyosefalik, 56 (%20.8)'sı brakiosefalik, 8 (%3)'i brakiobazilik A-V fistüllerdi. 3 (%1.1) vakada brakiyal arter ile ven arasına loop greft; 1 (%0.37)'er vakada ise radyal arter ile brakiyal ven arasına, brakiyal arter ile bazilik ven arasına ve yüzeyel femoral arter ile safen ven arasına greft konuldu. 198 radyosefalik A-V fistülün 24 (%12.1)'ü erken dönemde, 3 (%1.5)'ü ise geç dönemde inaktif hale geldiler. 56 brakiosefalik A-V fistülün 4 (%7.1)'ü, 8 brakiobazilik A-V fistülün 2 (%25)'si erken dönemde başarısız oldu. Greft ile A-V fistül açılan 6 hastanın 1 (%16.6)'inde geç dönemde greft tromboze oldu. Radyal seviyedeki A-V fistüllerde açık kalma oranı kadınlarda erkeklere göre daha az bulundu.(%82.3-%89.8). Brakiyal seviyedeki ve radyal seviyedeki A-V fistüllerin başarısı birbirine yakınken, radyal seviyedeki A-V fistüllerde kadınlarda erkeklere göre başarı oranı düşüktü. Greft ile A-V fistül açmak greft kullanmadan açılan A-V fistüllere üstünlük sağlamadı.

Anahtar Kelimeler:

Böbrek yetmezliği, kronik, Radial arter, Arteriyovenöz fistül, Brakiyal arter, Renal diyaliz, Geriyedönük çalışma, Vasküler açıklık

The patency rate of arteriovenous fistulas

The purpose of this investigation is to determine the patency of the arteriovenous (A-V) fistulas, created in patients with chronic renal failure, in the early and late periods according to sex. The A-V fistulas created for hemodialisis were investigated retrospectively. Of 238 patients, there were 130 male. 269 operations were made to 238 patients. Of these, 198 (73.6 %) were radiochephalic, 56 (20.8 %) were brachiochephalic, 8 (3 %) were brachiobasilic A-V fistulas. In 3 (1.1 %) patients loop graft between brachial artery and vein, in 1 (0.37 %) patient graft between radial artery and brachial vein, in 1 patient graft between brachial artery and basilic vein, in 1 patient graft between superficial femoral artery and saphenous vein were placed. Of 198 radiochephalic A-V fistulas 24 (12.1 %) in early period and 3 (1.5 %) in late period became inactive. Of 56 brachiochephalic A-V fistulas 4 (7.1 %) and of 8 brachiobasilic A-V fistulas 2 (25 %) became unsuccessful in early period. 1 of 6 A-V fistulas with prosthetic graft failed in late period because of thrombosis. In radial level patency rate of A-V fistulas in females were lower than in males (82.3 %-89.8 %). The patency rate of A-V fistulas in radial and brachial levels were similar, but in radial level rate of successful of A-V fistulas decreased in females according to males. Use of graft in A-V fistula didn't give superiority to A-V fistulas without graft.

Keywords:

Kidney Failure, Chronic, Radial Artery, Arteriovenous Fistula, Brachial Artery, Renal Dialysis, Retrospective Studies, Vascular Patency,

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