Early- and late results of anastomosis techniques for creation of brachiocephalic fistulas for hemodialysis

Patients and methods: Between January 2012 and December 2016, a total of 61 patients (37 males, 24 females; median age 59 years; range 44 to 72 years) who underwent arteriovenous fistula (AVF) operation for hemodialysis were retrospectively reviewed. Side-to-side (STS) and end-to-side (ETS) anastomosis techniques in the brachial region were compared in terms of patency and complication rates in the early- and late-term.

Results: There were 29 patients in the STS group and 32 patients in the ETS group. Although there was a proportional difference in the patency rates and complications between the groups, it was not statistically significant, particularly in the long-term period. The patency rates of STS and ETS at two years were 69% and 59.4%, respectively, indicating that none of the techniques was superior to the other. The presence of peripheral arterial disease and diabetes mellitus was the most significant factors affecting the patency rates.

Conclusion: Both ETS and STS anastomosis techniques should be planned individually. Although both techniques yield a similar patency rate, fistulas are superior to grafts and catheters. Fistulas, which may be the last chance of a patient, can be safely created using both techniques.