Objectives: In this study, we present our early and late results of different anastomosis techniques for the creation of brachiocephalic fistulas
for hemodialysis.
Patients and methods: Between January 2012 and December 2016, a total of 61 patients (37 males, 24 females; median age 59 years; range
44 to 72 years) who underwent arteriovenous fistula (AVF) operation for hemodialysis were retrospectively reviewed. Side-to-side (STS) and
end-to-side (ETS) anastomosis techniques in the brachial region were compared in terms of patency and complication rates in the early- and
late-term.
Results: There were 29 patients in the STS group and 32 patients in the ETS group. Although there was a proportional difference in the
patency rates and complications between the groups, it was not statistically significant, particularly in the long-term period. The patency
rates of STS and ETS at two years were 69% and 59.4%, respectively, indicating that none of the techniques was superior to the other. The
presence of peripheral arterial disease and diabetes mellitus was the most significant factors affecting the patency rates.
Conclusion: Both ETS and STS anastomosis techniques should be planned individually. Although both techniques yield a similar patency
rate, fistulas are superior to grafts and catheters. Fistulas, which may be the last chance of a patient, can be safely created using both
techniques.
Key words: Arteriovenous fistula, brachiocephalic, hemodialysis, patency.
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