EVALUATION OF RADIO-CEPHALIC ARTERIOVENOUS FISTULA FOR LONG TERM VASCULAR ACCESS

Background: Arteriovenous fistulae of various types can be made to provide vascular access for haemodialysis. This study was conducted to evaluate radio-cephalic arteriovenous fistula.Methodology: It was a cross-sectional interventional study conducted at Rehman Medical Institute, between 1st July 2009 and 30th August 2010. All patients with end stage renal disease requiring long term vascular access for haemodialysis were included in the study. Patients who previously had arteriovenous fistula were excluded. All the patients were operated by experienced surgeons under similar circumstances. In all patients, radio-cephalic fistula was created in the left forearm just above the wrist joint.Results: Forty patients were studied; 29(72.5%) males and 11(27.5%) females, with male to female ratio of 2.6:1. Distribution of co-morbid factors showed diabetes in 27(67.5%), hypertension in 12(30%) and coronary artery disease in 6(15%) patients. The procedure remained successful with well-functioning AV fistula at one month follow up (until the first successful haemodialysis) in 36 (90%) of the patients in the first attempt. In 4(10%) patients it failed in the first attempt in whom re-do procedure was carried out successfully at another (cubital) site. In 1 (2.5%) patient there was oedema of the fistula site and 1 (2.5%) had late maturation of the fistula.Conclusion: Radio-cephalic arteriovenous fistula in patients with end stage renal disease requiring long term vascular access for haemodialysis remains the procedure of choice if done by experienced hands