Your browser doesn't support javascript.
loading
End-to-side versus side-to-side anastomosis with distal vein ligation for arteriovenous fistula creation.
ElKassaby, Mohammed; Elsayed, Nashaat; Mosaad, Ahmed; Soliman, Mosaad.
Affiliation
  • ElKassaby M; Department of Vascular and Endovascular Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
  • Elsayed N; Department of Vascular and Endovascular Surgery, St Vincent's hospital, UCD, Dublin, Ireland.
  • Mosaad A; Department of Vascular and Endovascular Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
  • Soliman M; Department of Vascular and Endovascular Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Vascular ; 29(5): 790-796, 2021 Oct.
Article in En | MEDLINE | ID: mdl-33283667
INTRODUCTION: There is lack of compelling evidence about the best technique to carry out the anastomosis between the artery and the vein: end to side or side to side. This issue was addressed by very few randomized controlled studies. This topic has recently re-emerged with the advent of the endovascular fistula creation using the side-to-side technique.Objectives: To compare the results of both surgical techniques for the creation of arteriovenous anastomosis. METHODS: This is a randomized controlled prospective study. All renal failure patients, 18 years and older, referred to our institution requiring creation of a new arm arteriovenous fistulas, including distal radio-cephalic, ulno-basilic, proximal brachio-cephalic or brachio-basilic configurations were included. RESULTS: Between February 2018 and October 2018, 378 patients underwent creation of permanent haemodialysis access. A total of 100 patients were randomized equally into the end-to-side and side-to-side groups. Follow-up for the study purpose continued until May 2019 (mean = 9 months, range 1-12). Patients' age ranged from 19 to 68 years. Sevety-seven arteriovenous fistulas were created at the elbow (37 brachio-basilic and 40 brachio-cephalic). Radio-cephalic fistulae were 23, created at wrist and in the forearm. Primary technical success was 97%, and 35 (70%) and 17 (34%) cases achieved functionally maturation in the end-to-side and side-to-side groups, respectively (P = 0.0001). Primary and secondary patency rates at 12 months were 76% end to side versus 78% STS (P = 0.381) and 84% end to side versus 86% STS (P = 0.225), respectively. CONCLUSION: End-to-side technique should be used in all instances of arteriovenous fistulas creation.
Subject(s)
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Veins / Wrist / Arteriovenous Shunt, Surgical / Renal Dialysis / Renal Insufficiency / Forearm Type of study: Clinical_trials / Diagnostic_studies / Observational_studies Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: En Journal: Vascular Journal subject: ANGIOLOGIA / CARDIOLOGIA Year: 2021 Document type: Article Affiliation country: Egypt Country of publication: United kingdom

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Veins / Wrist / Arteriovenous Shunt, Surgical / Renal Dialysis / Renal Insufficiency / Forearm Type of study: Clinical_trials / Diagnostic_studies / Observational_studies Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: En Journal: Vascular Journal subject: ANGIOLOGIA / CARDIOLOGIA Year: 2021 Document type: Article Affiliation country: Egypt Country of publication: United kingdom