Nazmus SabahNational Institute of Cardiovascular Disease, Bangladesh
Title: A comparative study between radiocephalic and brachiocephalic arteriovenous fistula in end stage renal disease
Background: Chronic Kidney Disease (CKD) is a worldwide major public health problem. It is a long-term condition caused by damage to both kidneys. Patients with deteriorating renal function and end stage renal disease require vascular access that is safe, reliable, and associated with minimal complications. The utility of pre-operative colour Doppler to select the vessels for arteriovenous fistula creation was found to be as an essential parameter of pre-operative work up.
Objective: To compare the outcomes of Radiocephalic and Brachiocephalic arteriovenous fistula in end stage renal disease.
Materials and methods: It was quasi experimental study carried out Department of Vascular Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. The study was conducted from June 2019 to May 2020. Patients were end stage renal disease patients who needs arteriovenous fistula creation for hemodialysis. Total 60 patients were included in this study. The patients divided into two groups (30 patients Group I was Radiocephalic arteriovenous fistula patients and 30 patients Group II Brachiocephalic arteriovenous fistula patients). After editing data analysis will be carried out by using the Statistical Package for Social Science (SPSS Inc., Chicago, Illinois, USA) version 22.0 windows software.
Result: This study shows 60% were male and 40% were female Radiocephalic arteriovenous fistula patients. On the other hand, in Brachiocephalic arteriovenous fistula 73.3% were male and 26.7% were female. It was observed that Q max was statistically significantly higher in Brachiocephalic arteriovenous fistula patients than Radiocephalic arteriovenous fistula patient which was 769.11±101.54 vs 626.37±55.81 respectively (P=0.001). Maturation time was statistically significantly lower in Brachiocephalic arteriovenous fistula patients than Radiocephalic arteriovenous fistula patients which was 37.78±1.93 vs 43.33±2.12 respectively (P=0.001). Complication was more in Radiocephalic arteriovenous fistula patients (Group I) than Brachiocephalic arteriovenous fistula patients (Group II) which was 16.7% vs 3.3% respectively.
Conclusions: This study shows that the Brachiocephalic AVF maturation time was significantly less than the maturation time of Radiocephalic AVF and rate of complication was less in Brachiocephalic AVF. The utility of pre-operative colour Doppler to select the vessels for AVF creation was found to be as an essential parameter of pre-operative work up.
To be updated