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Results of arteriovenous fistula revision in the forearm
H Yasuhara1, H Shigematsu, T Muto
1Department of Surgery I, University of Tokyo, Bunkyo-ku, Japan.
Purpose:
We assessed the usefulness of revision for hemodialysis arteriovenous fistulae.
Methods:
From 1985 to 1994, 287 arteriovenous fistulae were created at our facility. "Primary" patency was defined as the duration of fistula patency without revision, and "secondary" patency was defined as the duration of fistula patency after successful revision in the forearm not requiring prosthesis.
Results:
The secondary patency rate was significantly better than the primary patency rate (89% versus 41% at 5 years, P < 0.01). The secondary patency rate in diabetic patients did not differ from that in nondiabetics, although there was a significant difference in the primary patency rate between these two patient groups (diabetics 30% versus nondiabetics; 45% at 5 years, P < 0.01).
Conclusions:
Revision is a reliable procedure for salvaging a failed fistula, which yields an acceptable patency rate regardless of the patient's risk factors for arteriosclerosis.