New Probing andWarmWashing Technique in Arteriovenous Fistula Surgery: Early Results of a Single Center

Objective: Arteriovenous fistulas (AVF) are frequently used in patients with endstage renal failure. Several anastomosis have been defined for creating AVF. In this paper, we aimed to describe a novel approach to AVF surgery with an additional maneuver which can be applied in all surgical techniques, and to present our early results with this novel approach. Material and Methods: Thirty one patients with end-stage renal failure presented to our department for AVF surgery. There were 24 males and 7 females with a mean age of 58 years. We performed end-to-side anastomosis technique together with our novel method in all of our patients. In surgical technique, classical maneuvers were performed until the end of the anastomosis. At this time, vein lumen was washed with low-dose heparinized warm fluid using a simple catheter, which was inserted into the vein lumen, as the probes used in coronary anastomosis. Results: Mean vein diameter before surgery was 2.87±0.37 mm. Mean flow rate was 200.15±49.37 ml/min 24 hours, 299.03±81.34 ml/min one week, and 505.98±161.1 ml/min 3 weeks after surgery (p<0.001). Three patients needed surgical revision in first month, all of which were secondary to insufficient venous diameter and blood flow. Conclusion: We used this novel technique as an additional method in our patients with good results, and without any complications. We believe that this method may increase the early patency rates of fistulas by preventing thrombus formation and vasospasm.