Ahmed, Y., abdewahab, M., Abd El-Mabood, E., Ali, H. (2024). Surgical Management of Failing Arteriovenous Fistula as a hemodialysis Access. Benha Medical Journal, (), -. doi: 10.21608/bmfj.2024.229734.1876
Yasin Mahmoud Ahmed; mostafa baumy abdewahab; El-Sayed Afifi Abd El-Mabood; Hazem El-Sayed Ali. "Surgical Management of Failing Arteriovenous Fistula as a hemodialysis Access". Benha Medical Journal, , , 2024, -. doi: 10.21608/bmfj.2024.229734.1876
Ahmed, Y., abdewahab, M., Abd El-Mabood, E., Ali, H. (2024). 'Surgical Management of Failing Arteriovenous Fistula as a hemodialysis Access', Benha Medical Journal, (), pp. -. doi: 10.21608/bmfj.2024.229734.1876
Ahmed, Y., abdewahab, M., Abd El-Mabood, E., Ali, H. Surgical Management of Failing Arteriovenous Fistula as a hemodialysis Access. Benha Medical Journal, 2024; (): -. doi: 10.21608/bmfj.2024.229734.1876
Surgical Management of Failing Arteriovenous Fistula as a hemodialysis Access
1Department of General Surgery Faculty of Medicine, Banha University
2Professor of General Surgery, Faculty of Medicine, Benha University
3Professor of General and Vascular Surgery, Faculty of Medicine, Benha University
4Assistant Professor of General Surgery, Faculty of Medicine, Benha University
Abstract
Arteriovenous fistulas (AVFs) are the preferred vascular access for hemodialysis in patients with CKD. However, AVFs can encounter complications that lead to access failure, requiring surgical intervention. This study aimed to evaluate the effect and effort of surgical management of access failure after creation regarding to patency rate, complication rate and mortality rate. Methods: This prospective study enrolled 20 patients with chronic kidney disease and AVF complications after creation. Inclusion criteria included age between 12-75 years, chronic renal failure with autogenous dialysis access, and confirmed AVF stenosis or other complications. Demographic data, comorbidities, clinical examinations, laboratory tests, imaging studies, and preoperative ultrasound assessments were collected. Detailed information on AVF specifics, surgical procedures performed, salvage interventions, patency measurements, and complications were documented. Results: The study included patients with a mean age of 55.5 ± 14.7 years, with a higher distribution in the age group of 41-60 years. Diabetes was the most prevalent comorbidity among the studied patients. Brachio-cephalic fistulas were the most common type of access, and thrombosis and infection were the primary complications observed. The primary patency rate was 2.3 ± 1.9 years, while secondary patency showed a decline over time. Complications such as hematoma, infection, and thrombosis were recorded, with varying rates of wound healing outcomes.