A venous ""patch"" technique improves patency rate of primary radiocephalic fistulas

A retrospective study was designed to evaluate the outcome of native wrist arteriovenous fistula (AVF) constructed with standard versus venous ""patch"" techniques in terms of immediate, early and late failures. Between January 1991 and July 2001, 1948 patients underwent primary wrist radiocephalic AVF. Thirty eight per cent (740) of the fistulas were created using the venous patch technique. Immediate and/or early failure rate was significantly lower in the venous ""patch"" technique (Group II) compared to the standard technique (Group I). Although the difference in late failures between Groups I and II did not reach statistical significance, the cumulative patency rates were significantly better in Group II. Radiocephalic fistula constructed with the use of venous patch is recommended whenever the anatomy is feasible.