Arteriovenous fistula creation using the Brescia-Cimino technique compared to the fish-mouth anastomosis technique for hemodialysis access

Patients and methods: Between January 2010 and March 2011, 40 patients (8 males, 32 females; mean age 52.7 years; range, 28 to 63 years) who underwent the forearm arteriovenous fistula procedure due to end-stage renal disease were included in this study. The patients were divided into two groups, depending on the surgical technique employed. Group 1 included 20 patients operated using the Brescia-Cimino technique, while Group 2 included 20 patients operated using the fish-mouth technique. The diameters of the radial artery and cephalic vein were measured pre- and at postoperative Days 1, 7, and 30. The arteriovenous fistula flow rate was measured using Doppler US at postoperative Day 30.

Results: The mean preoperative cephalic vein diameters were 2.48±0.4 mm in Group 1 and 2.03±0.4 mm in Group 2 (p=0.004). The mean preoperative radial artery diameters were 2.46±0.5 mm in Group 1 and 2.04±0.2 mm in Group 2 (p=0.003). The mean arteriovenous fistula flow rates at Week 4 were 547±149 mL/min in Group 1 and 745±108 mL/min in Group 2 (p<0.001). Early complication rates and surgery times were lower in the fish-mouth group.

Conclusion: Fish-mouth anastomosis appears to be an efficient and safe technique for arteriovenous fistula creation with a lower complication rate and shorter operation time.