Comparative study of the effects of two suturing techniques of End-to-side arteriovenous anastomosis on early outcomes of radio-cephalic fistulas
Comparative study of the effects of two suturing techniques of End-to-side arteriovenous anastomosis on early outcomes of radio-cephalic fistulas
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Introduction: Radiocephalic arteriovenous fistulas (AVFs) for dialysis have significantly high maturation failure rate.Many surgical technique-related factors are known to impact the outcomes of AVF surgery; anastomotic suturing technique is one such factor for AEG DCE5960HM 90cm Ceiling Extractor Stainless Steel which the published data is sparse.Patients and Methods: We retrospectively analyzed the data of patients who underwent end-to-side radio-cephalic AVF surgery during a 2-year period and grouped it according to the two techniques of anastomotic suturing: Anchor technique and parachute technique.
Comparative analysis was done to study the effect of the technique on well-defined outcomes within the first 6 months of surgery.Results: A total of 119 AVFs (anchor technique = 65, parachute technique = 54) were included in the study.The aggregated primary patency at 6 weeks and 6 months was 85.
7% and 78.1% respectively and successful use of fistula was seen in 62.2%.
The parachute technique was associated with lower immediate access thrombosis (3.7% vs.15.
4%, P = 0.019) and primary failure (31.5% vs.
43%, P = 0.033) than the anchor technique.The groups did not differ statistically in outcomes like early access failure (P = 0.
376), maturation failure (P = 0.105), primary patency at 6 weeks (P = 0.07) and at 6 months (P = 0.
083) and successful use of fistula at 6 months (P = 0.196).Conclusion: In this retrospective single-center study, the parachute technique of anastomotic suturing was associated with lower incidence of immediate access failure of radio-cephalic AVF as compared to the anchor technique, although other early outcomes were similar with both techniques.
The effects Balboa L/S Tees of different suturing techniques on surgical outcomes of AVF should be studied in large randomized trials.