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KMID : 1037520140300010033
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Vascular Specialist International
2014 Volume.30 No. 1 p.33 ~ p.37
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Successful Access Rate and Risk Factor of Vascular Access Surgery in Arm for Dialysis
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Yoo Dae-Woo
Yoon Myung-Hee
Jun Hee-Jae
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Abstract
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Purpose: Preservation of adequate vascular access is of vital importance for pa-tients undergoing chronic dialysis in renal failure. The aim of this study is to eva-luate the successful access rate and risk factors of arteriovenous fistula (AVF) in the arm for dialysis at a single center.
Materials and Methods: Patients undergoing vascular access operation between January 2006 and December 2011 were retrospectively identified.
Results: A total of 362 vascular access operations were performed. There were 338 autologous AVFs (93.4%) and 24 prosthetic grafts (6.6%). Men comprised 58.3% of all subjects. Mean age was 59.5±14.7 years. There were 187 diabetes mellitus patients (51.7%). There was a mean duration of 70.3±21.1 days between access cr-eation to first cannulation. Overall successful access rate for dialysis was 95.9%. Of 338 autologous AVFs, 326 patients had patent AVFs for dialysis (96.4% surgical success rate), while 21 of 24 prosthetic grafts were patent (87.5% surgical success rate). A total of 141 patients (38.9%) came to surgery with preoperative central venous catheters (CVC) of which 130 (35.9%) AVFs had a patent fistula in the arm. The only risk factor related to successful access rate of AVF was preoperative CVC placement (P=0.012).
Conclusion: Successful vascular access rate was 95.9%. The only risk factor related to patent access of AVF was preoperative CVC placement. At least 6 months prior to expected dialysis, AVF surgery is recommended, which may overcome the challenge of co-morbid conditions from having a preoperative CVC.
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KEYWORD
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Arteriovenous fistula, Patency, Renal insufficiency
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