From the Department of Surgery, Shohada Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
Abstract: (5257 Views)
Over a seven year period from 1982 to 1989,3337 conduits were created
in 3137 patients with end stage renal disease (ESRD) as access for chronic
dialysis. These included 2690 side-to-side arteriovenous fistulae (A VF), 168
end-to-side A VFs, 10 autogenous vein grafts, 51 homogenous frozen vein
grafts, 109 polytetrafluoroethylene (PTFE) grafts, 209 emergency external
arteriovenous shunts, three dual-lumen catheter placements with dacron felt
cuff in the superior vena cava and 13 miscellaneous vascular access procedures.
Our favorite site for creation of A VFs along with satisfactory patency
rates for as long as seven years are demonstrated for all types of fistulae and
PTFE grafts by life-table analysis.
Early failure of A VFs usually occurred in the postoperative period due
to hypotension, and late failures were due to improper use of the vein during
dialysis.
Thrombosis was the cause of the majority of the PTFE graft failures,
even though we had four cases of infection more than one year later and one
case of seroma formation due to weeping of the graft. False aneurysm
formation and secondary bleeding requiring repair were the major complications
of PTFE grafts.
Autogenous or frozen banked homogenous vein graft failures were
mainly due to gradual fibrosis and narrowing and eventual thrombosis, while
we did not have infection or false aneurysm formation or any other
complication with them.
Type of Study:
Original Research |
Subject:
Surgery