Al-Madhhachi Bahaa A
Iraqi Board of Cardiothoracic and Vascular Surgery, Department of Surgery, University of Kufa-College of medicine, Najaf Governorate, Iraq.
SAGE Open Med. 2022 Jan 21;10:20503121211069280. doi: 10.1177/20503121211069280. eCollection 2022.
When created in appropriately selected patients, arteriovenous fistula requires fewer interventions and costs compared to arteriovenous graft. The outcome of radiocephalic after brachiocephalic and redo arteriovenous fistula is not studied well in the literature, and this study highlights the outcome of these arteriovenous fistulae.
The retrospective, single-center study, based on patient record analysis of 1040 arteriovenous fistula, was created between January 2017 and October 2021. Thirty-nine (3.37%) patients met the inclusion criteria for radiocephalic after brachiocephalic arteriovenous fistula group, and 42 (4.04%) met the inclusion criteria for the redo arteriovenous fistula group. Preoperative Doppler ultrasound was performed by the operating surgeon in all patients. All patients were scheduled for a visit 2 months after surgery for assessment-only 34 of radiocephalic after brachiocephalic arteriovenous fistula and 35 of redo arteriovenous fistula patients presented for follow-up. The arteriovenous fistula was assessed for patency, maturation, and complications. SPSS version 22 (Chicago, USA) was used for data entry and analysis.
The redo arteriovenous fistula has a significantly lower maturation rate at 2 months of follow-up (62.85%) when compared to other brachiocephalic arteriovenous fistula (79.18%) (-value = 0.0245). The radiocephalic after brachiocephalic arteriovenous fistula has no significant difference in maturation rate at 2 months of follow-up (61.67%) when compared to other distal forearms radiocephalic arteriovenous fistula (68.18%) (-value = 0.5173). The incidence of some early complications was higher in the redo group.
The feasibility of doing radiocephalic arteriovenous fistula after failed brachiocephalic arteriovenous fistula is generally overlooked. The redo arteriovenous fistula is more technically challenging, associated with higher complications, but it provides reliable access in a specific group of patients.
在适当选择的患者中创建动静脉内瘘时，与动静脉移植物相比，所需的干预措施和成本更少。文献中对肱头动静脉内瘘术后头静脉桡动脉内瘘的结果研究不足，本研究重点关注这些动静脉内瘘的结果。
这项回顾性单中心研究基于对2017年1月至2021年10月期间创建的1040例动静脉内瘘患者记录的分析。39例（3.37%）患者符合肱头动静脉内瘘术后头静脉桡动脉内瘘组的纳入标准，42例（4.04%）患者符合再次动静脉内瘘组的纳入标准。所有患者术前均由手术医生进行多普勒超声检查。所有患者术后2个月安排复诊——肱头动静脉内瘘术后头静脉桡动脉内瘘组仅34例、再次动静脉内瘘组仅35例患者前来进行随访。对动静脉内瘘的通畅性、成熟度和并发症进行评估。使用SPSS 22版（美国芝加哥）进行数据录入和分析。
与其他肱头动静脉内瘘（79.18%）相比，再次动静脉内瘘在随访2个月时的成熟率显著较低（62.85%）（P值 = 0.0245）。肱头动静脉内瘘术后头静脉桡动脉内瘘在随访2个月时的成熟率（61.67%）与其他前臂远端头静脉桡动脉内瘘（68.18%）相比无显著差异（P值 = 0.5173）。再次手术组一些早期并发症的发生率较高。
肱头动静脉内瘘失败后进行头静脉桡动脉内瘘的可行性通常被忽视。再次动静脉内瘘在技术上更具挑战性，并发症更多，但它为特定患者群体提供了可靠的血管通路。
