A Comparative Study between Radiocephalic and Brachiocephalic Arteriovenous Fistula in End Stage Renal Disease

Cardiovascular Journal Pub Date : 2021-09-15 DOI:10.3329/cardio.v14i1.55373

Nazmus Sabah, S. Ahmed, S. Khan, R. Hasan, Fidah Hossain, Manifa Naz Fatma

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Abstract

Background: Chronic Kidney Disease (CKD) is a major health issue all over the world. Patients with deteriorating renal function and end-stage renal disease require vascular access for hemodialysis. Studies suggest that Arterio-Venous fistula (AVF) constructed judiciously using autologous conduit give the best outcome in this regard. Objective of the study was to compare the outcomes of Radiocephalic and Brachiocephalic AVF in end stage renal disease (ESRD). Methods: It was a quasi-experimental study carried out at the Department of Vascular Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. The study was conducted from June 2019 to May 2020. Patients suffering from ESRD underwent AVF creation surgery for hemodialysis access. A total of 60 (Sixty) patients were included in this study. The patients were divided into two groups; Group I included 30 patients who underwent Radiocephalic AVF operation and Group II included 30 patients who had Brachiocephalic AVF operation. Results: In Group I, (Radiocephalic AVF) 60% were male and 40% were female. On the other hand, in Group II (Brachiocephalic AVF) 73.3% were male and 26.7% were female. Calculated volume flow (Q max) was significantly higher in Group II compared with Group I (769.11±101.54 ml/min vs 626.37±55.81) ml/min) with the difference being statistically significant (P=0.001). Maturation time was significantly less in Group II compared with Group I )37.78±1.93 vs 43.33±2.12 days) with the difference between the two group being statistically significant (P=0.001). Complication was more in Group I than Group II (16.7% vs 3.3%). Conclusion: The present study shows that Brachiocephalic AVF gives significantly better outcome in terms of shorter maturation time and less complications compared with Radio-Cephalic AVF. Color Doppler study is an essential tool for preoperative vessel evaluation which guides the selection of suitable AVF construction site. Cardiovasc j 2021; 14(1): 44-49

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终末期肾病放射性头静脉瘘与头臂动静脉瘘的比较研究

背景:慢性肾脏疾病(CKD)是世界范围内的主要健康问题。肾功能恶化和终末期肾病患者需要血管通路进行血液透析。研究表明，在这方面，明智地使用自体导管构建动静脉瘘(AVF)可以获得最佳效果。本研究的目的是比较放射性和头臂性AVF在终末期肾病(ESRD)中的预后。方法:准实验研究在达卡Bangabandhu Sheikh Mujib医科大学血管外科(BSMMU)进行。该研究于2019年6月至2020年5月进行。ESRD患者接受AVF创建手术以获得血液透析通路。本研究共纳入60例患者。患者分为两组;第一组30例行放射性头侧AVF，第二组30例行肱头侧AVF。结果:第一组(放射性头性AVF)男性占60%，女性占40%。II组(头臂AVF)男性占73.3%，女性占26.7%。计算容积流量(Q max) II组显著高于I组(769.11±101.54 ml/min vs 626.37±55.81)ml/min)，差异有统计学意义(P=0.001)。成熟时间(37.78±1.93 vs 43.33±2.12)明显少于成熟时间(P=0.001)。I组并发症发生率高于II组(16.7% vs 3.3%)。结论:与放射头侧AVF相比，头臂侧AVF在成熟时间短、并发症少等方面具有明显的优势。彩色多普勒研究是术前血管评估的重要工具，指导选择合适的AVF建设地点。心血管病杂志2021;14 (1): 44-49

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Cardiovascular Journal

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