Background: Radio-cephalic arteriovenous fistula (RC-AVF) is considered the preferred vascular access for dialysis, particularly in the non-dominant arm. However, elderly patients and those with comorbidities have a higher failure rate of RC-AVF. Therefore, clinical examination before surgery is crucial, and careful postoperative monitoring is necessary to overcome impaired fistula maturation. This study aims to evaluate different factors that may affect the outcome of arteriovenous fistula creation.
Methods: The study included patients aged 20-65 years with chronic kidney disease, without prior radio-cephalic arteriovenous vascular access intervention, from February 1, 2021, to January 31, 2022. Factors affecting the outcome were assessed, including preoperative, intraoperative, and postoperative factors. In this study, an end-to-side anastomosis technique was used with prolene 7-0 suture material in an interrupted suturing technique.
Results: Out of 250 patients, the highest successful AVF creation rate was observed in the 20-30 years age group (84%), followed by the 31-40 years and 41-50 years age groups (78%). The success rate was found to be higher in males (61%) than in females (39%). Moreover, the success rate of AVF had an incremental relation with the diameter of the radial artery and cephalic vein.
Conclusion: The success of fistula maturation is strongly correlated with postoperative monitoring. Therefore, AV fistula monitoring should begin immediately during surgery and continue in the postoperative period.
