Clinical records of 55 operations of internal arteriovenous fistulas in 45 patients between Aug. 1989 and Oct. 1991 in Daejon Eulji General Hospital were reviewed and the results are:
1) The 51 operation sites were snuffbox(11), conventional radiocephalic at wrist(20), proximal radiocephalic(9), ulnarbasilic(2), brachiobasilic(6), brachiocephalic(3), Reoperation cases were 33%(18/55).
2) There were 10 early failures(18%) in 6 patients consisting of 7 cases of thrombosis and 3 cases of poor flow.
The cause of 7 failures in 4 patients was poor condition of usable vein i.e.small size and outflow obstruction.
3) There were 4 cases of late obstruction during the follow-up period. Average follow-up period was 12.6±9.9(±S.D.) months and ranged from 1 to 28 months, and cumulative patency rate except early failures was 94% at 6 and 12 months, and 83% at
18
months.
4) There were 10 cases of reoperation for late obstruction with average duration of patency of 19.9±9.7 months.
The sites of obstruction were distal vein near anastomotic site(4), proximal(2), diffuse(2), proximal & distal(1) in 9 cases.
New fistulas were placed on proximal dilated cephalic (6) and basilic (2) vein in 8 cases.
5) Preoperative angiography was done in 2 cases to determine operation site, and intraoperative angiography was done in 3 late obstruction cases to confirm outflow patency.
2 attemps of thrombectomy failed in late obstruction cases.
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