P-ISSN 2587-2400 | E-ISSN 2587-196X
Eurasian Journal of Medicine and Oncology Complications of Arteriovenous Fistula Created for Hemodialysis Access and Treatment Approaches [EJMO]
EJMO. 2017; 1(2): 76-81 | DOI: 10.14744/ejmo.2017.83997

Complications of Arteriovenous Fistula Created for Hemodialysis Access and Treatment Approaches

Serdar Demiral1, Ozlem Turkoglu2, Zafer Turkoglu3
1Department of General Surgery, Acibadem Hospital, Istanbul, Turkey
2Department of Radiology, Haydarpasa Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
3Department of Dermatology, Haseki Training and Research Hospital, Istanbul, Turkey

Objectives: Patients with chronic renal failure who are treated with hemodialysis need a patent arteriovenous fistula (AVF). This study was an analysis to determine the best approach to prevent complications and provide treatment.
Methods: In this retrospective study, a total of 437 AVF patients’ medical records and postoperative epicrisis with 4 years of clinical follow-up were evaluated. The preferred method of anastomosis surgery was the end-to-side technique. Complications were divided into categories of early (seen within 48 hours), and late (after 48 hours).
Results: Of 437 patients, 288 (65.9%) were men, and the remaining 149 (34.1%) were women. The mean age was 46 years (range: 20-72 years). The locations of fistulas were snuffbox (n=42; 8.5%), radiocephalic (n=298; 60.9%), brachiocephalic (n=126; 25.6%), and brachiobasilic (n=25; 5%). Early complications were thrombosis (n=57; 69.5%), bleeding (n=14; 17%), and hematoma (n=11; 13.4%). Late complications observed were thrombosis/stenosis (n=25; 39.6%), venous hypertension (n=4; 6.3%), aneurysmatic dilatation (n=12; 19%), infection (n=6; 9.5%), bleeding/hematoma (n=7; 11.1%), arterial steal syndrome (n=4; 6.3%), congestive heart failure (n=1; 1.5%), seroma (n=2; 3.1%), and neuropathy (n=2; 3.1%). The most frequent of 145 total complications observed during the follow-up period was thrombosis (n=82; 16.7%).
Conclusion: The benefits of ultrasound assistance in both the control and treatment of bleeding was also a supportive measure for the management of complications, such as steal syndrome, as it can be used to develop the best treatment strategy by considering flow velocities, or in the case of venous hypertension, to detect central stenosis. Embelectomy with re-operation may be preferred in a case of thrombosis, rather than embelectomy alone, as it is a time-consuming procedure and was reported in our clinic to be less effective when a standalone procedure.

Keywords: Arteriovenous fistula, complication, thrombosis, treatment

Serdar Demiral, Ozlem Turkoglu, Zafer Turkoglu. Complications of Arteriovenous Fistula Created for Hemodialysis Access and Treatment Approaches. EJMO. 2017; 1(2): 76-81

Corresponding Author: Ozlem Turkoglu, Türkiye

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