Fokou Marcus, Teyang Abel, Ashuntantang Gloria, Kaze Francois, Eyenga Victor Claude, Chichom Mefire Alain, Angwafo Fru
Department of Surgery, Yaoundé General Hospital, Yaoundé, Cameroon.
Ann Vasc Surg. 2012 Jul;26(5):680-4. doi: 10.1016/j.avsg.2011.09.014. Epub 2012 Apr 24.
To assess the frequency and characteristics of complications of arteriovenous fistula (AVF) and their effect on fistula outcome.
We retrospectively reviewed 628 AVFs constructed from November 2002 to October 2010 to record the complications and their management options. The association between age, sex, comorbidities (HIV, hypertension, and diabetes), fistula type, and complications was sought.
Most patients were males (73.7%). The mean age was 45.3 years. Comorbidities seen included diabetes mellitus (22.12%), hypertension (83.12%), and HIV infection (9.87%). AVFs constructed were mainly radiocephalic (68%) and brachiocephalic (24.9%). The median follow-up period was 275 days. The cumulative patency rate was 76% and 51% at 1 year and 2 years, respectively. Altogether, 211 complications occurred in 16% of the AVFs. Among them, 36.96% were severe, 25.11% moderate, and 43.91% minor. With respect to the time of occurrence, 63.98% were late complications, 12.79% immediate, and 23.22% early. Aneurysms, failure to mature, and thrombosis were the most frequent complications occurring in 26.54%, 14.69%, and 12.79% of cases, respectively. The management options for the complications included the creation of a new access in 36.96%, a temporary catheter before a new AVF in 10.52%, and nonoperative management in 43.12%. We found no adverse effect of comorbid factors such as diabetes mellitus (χ(2) = 3.58, P > 0.05) or HIV-positive status (χ(2) = 0.64, P > 0.05) on the complication rate.
This study shows an overall frequency of complications of 16%. These results show the potential for low complication rate of AVF in selected population.
评估动静脉内瘘（AVF）并发症的发生率、特点及其对内瘘结局的影响。
我们回顾性分析了2002年11月至2010年10月期间构建的628例AVF，记录并发症及其处理方式。探讨年龄、性别、合并症（HIV、高血压和糖尿病）、内瘘类型与并发症之间的关联。
大多数患者为男性（73.7%）。平均年龄为45.3岁。观察到的合并症包括糖尿病（22.12%）、高血压（83.12%）和HIV感染（9.87%）。构建的AVF主要为桡动脉-头静脉内瘘（68%）和肱动脉-头静脉内瘘（24.9%）。中位随访期为275天。1年和2年的累积通畅率分别为76%和51%。共有211例并发症发生在16%的AVF中。其中，36.96%为严重并发症，25.11%为中度并发症，43.91%为轻度并发症。就发生时间而言，63.98%为晚期并发症，12.79%为即刻并发症，23.22%为早期并发症。动脉瘤、未成熟和血栓形成是最常见的并发症，分别发生在26.54%、14.69%和12.79%的病例中。并发症的处理方式包括36.96%的患者建立新的血管通路，10.52%的患者在建立新的AVF前使用临时导管，43.12%的患者采用非手术治疗。我们发现糖尿病（χ(2)=3.58，P>0.05）或HIV阳性状态（χ(2)=0.64，P>0.05）等合并因素对并发症发生率无不良影响。
本研究显示总体并发症发生率为16%。这些结果表明在特定人群中AVF并发症发生率较低的可能性。
