Effect of Intra Operative Intravenous Injection of Heparin on Patency Rate of Radio Cephalic Autogenous Arteriovenous-Fistula in Chronic Renal Failure Patients

Background: Currently, there is no standard for the use of systemic heparin during creation of Arteriovenous (AV) fistula to decrease the incidence of postoperative thrombotic complications. Objectives: The goal of this study was to evaluate the effects of intra-operative IV heparin on patency rate and postoperative bleeding complications in patients undergoing surgery for AV fistula. Patients and Methods: A prospective, randomized controlled study was performed on 50 patients undergoing AV fistula creation, who were randomly divided in two groups. The control group received no systemic heparin and the heparin group received 5,000 units of intravenous heparin before clamping of theartery. Results: There was a significant difference in patency rate between the heparin and control groups (96% vs. 72%, P = 0.021), and there were no significant differences in operative time (P = 0.55). Perioperative bleeding was not significantly different between the two groups. Conclusions: The results suggest that intra operative administration of heparin has statistically significant effects on patency rates yet not on postoperative bleeding complications. Larger trials with longer follow-up durations and assessment of maturation rates are needed to determine this effect on fistula outcome.