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[110 surgical arteriovenous fistulas in 89 children]
J Guitard1, J Moscovici, M Visentin
1Département de Chirurgie Pédiatrique, Hôpital Purpan, Toulouse.
Insights
This study analyzed 110 arteriovenous fistulas for hemodialysis, chemotherapy, and nutrition, finding improved immediate functionality to 92%. Early complications include thrombosis, while delayed issues involve infections and stenosis.
Area of Science:
- Vascular Surgery
- Nephrology
- Oncology
Context:
- Arteriovenous fistulas (AVFs) are crucial vascular access for hemodialysis, chemotherapy, and parenteral nutrition.
- This study examines 110 AVFs, focusing on types, functionality, and complications.
Purpose:
- To evaluate the efficacy and complication rates of different AVF types used for various medical interventions.
- To report on the functional outcomes and long-term complications of AVFs.
Summary:
- The side-end radial AVF and humero-basilic shunt are the most utilized types.
- Immediate fistula functionality improved significantly from 81% to 92% over the past year.
- Early complications are dominated by thrombosis; delayed complications include thrombosis, infections, hand trophic disturbances, stenosis, and hemodynamic issues like hyper-flow.
Impact:
- Findings guide the selection of optimal AVF types for specific clinical applications, such as hemodialysis and chemotherapy.
- Improved understanding of AVF complications can lead to better patient management and outcomes.
- The study highlights the importance of monitoring for both early and delayed complications to ensure long-term vascular access patency.
Abstract:
110 arteriovenous fistulas made for hemodialysis, chemotherapy and extended parenteral nutrition are studied. For authors, the side-end radial arteriovenous fistula is the main used, followed by the humero-basilic shunt. The immediately functional fistula's percentage was of 81% with a net progress in the last year since it is now at 92%. Thrombosis prevails in early complications. 32% of delayed complications are minutely studied. They include thrombosis, infections, trophic disturbance of hands, secondary stenosis, hyper-flow with cardiac consequences. Others more unusual delayed complications are described ("Stealing" syndrome, no venous distention, bleeding, pseudo-aneurysm). The authors advice the side-end arteriovenous fistula for hemodialysis and humero-basilic shunt with immediately basilic superficialization for infant's hemodialysis, for chemotherapy and parenteral nutrition.