Seyhan YILMAZ, Serdar GÜNAYDIN, Eray AKSOY

Radio-medyan cubital arteriovenous fistula creation for hemodialysis access

Amaç: Bu çalışmada standart radiosefalik fistüloluşturulmasına uygun olmayan hastalarda radio-medyankubital arteriyovenöz fistül (AVF) oluşturulmasına dairkurumsal deneyimimizin sunulması amaçlandı.Çalışmaplanı: Standart radiosefalik fistül oluşturulmasınauygun olmayan 66 hastada (31 erkek, 35 kadın; ort. yaş49.6 yıl; dağılım 22-77 yıl) radio-medyan kubital AVFoluşturuldu. Çalışma prospektif olarak gerçekleştirildi.Tüm hastalar ameliyat sonrası 15. gün ve altıncı aydadubleks Doppler ultrason ile incelendi.Bul gu lar: Ameliyat sonrası erken komplikasyonlar-ameliyat sonrası 15 gün içinde- 10 hastada (%15.1)görüldü. On beşinci gündeki ilk takipte, 66 hastanın64ünün (%97.0) AVFsi patent idi. Altıncı ay takibinde, 61hastanın 56sının (%91.8) AVFsi patent idi. Arteriyovenözfistülleri patent olan hastaların üçü (%5.0) altı ay içindehemodiyalize başlatılmadı. Hastaların hiçbirinde ameliyatsonrası altı ay içinde çalma sendromu belirtisi yoktu.Sonuç: Standart radiosefalik fistül oluşturulmasınauygun olmayan hastalarda radio-medyan kubital AVFoluşturulması tekniğini kullanarak iyi sonuçlar elde ettik.Bu teknik el bileği seviyesinde zayıf venöz veya arteriyelyapısı olan hastalar için iyi bir alternatif olabilir.

Hemodiyaliz erişimi için radio-medyan kubital arteriyovenöz fistül oluşturulması

Background: This study aims to present our institutionalexperience regarding radio-median cubital arteriovenousfistula (AVF) creation in patients unsuitable for standardradiocephalic fistula creation. Methods: Radio-median cubital AVF was created in 66patients (31 males, 35 females; mean age 49.6 years; range 22to 77 years) who were unsuitable for standard radiocephalicfistula creation. The study was performed in a prospectivemanner. All patients were analyzed with duplex Dopplerultrasonography at postoperative 15 th day and sixth month. Results: Early postoperative complications -withinpostoperative 15 days- were observed in 10 patients(15.1%). At first follow-up on 15 th day, 64 in 66 patients(97.0%) had patent AVF. At sixth month follow-up, 56 in61 patients (91.8%) had patent AVF. Three patients (5.0%)with patent AVFs were not initiated on hemodialysiswithin six months. None of the patients had signs of stealsyndrome within postoperative six months. Conclusion: We achieved satisfactory results usingradio-median cubital AVF creation technique in patientsunsuitable for standard radiocephalic fistula creation. Thistechnique may be a good alternative for patients with poorvenous or arterial structure at the level of wrist.

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