Üst Ekstremite Diyaliz Erişim Yollarının Otolog veya Sentetik Greft İnterpozisyonu ile Kurtarılması

We examined the outcomes of upper extremity arteriovenous fistulas that were salvaged by an interposed autologous or synthetic graft. Patients who were operated for a failed upper extremity arteriovenous fistula and in whom a new proximal arteriovenous fistula was created by interposing an autologous or synthetic graft were identified from a prospectively maintained database. The outcomes were retrospectively analyzed. 11 patients with failed upper extremity arteriovenous fistulas were operated for creation a new hemodialysis access on the same extremity. Saphenous vein was the autologous graft in nine patients. In two patient, 6 mm PTFE graft was used. 4 of 11 patients were men. Mean age was 59±8.6 years. 7 of them were diabetic. The patients were follow up 3 months to twelve months. The conduits were examined with doppler ultrasonography during the follow up period ; the blood flow across the conduit and the diameter of the conduit were recorded. The patency rates were 90,90% in the twelve months follow up. Interposing an autologous and even a synthetic graft for creating a proximal arteriovenous fistula on the same extremity with a failed distal arteriovenous fistula demonstrates good patency.