Comparison of Results of Radiocephalic Arterio- Venous (RCAV Fistulas for Long-Term Hemodialysis between, Original Technique and Pongsapak Modified Technique
Abstract
Background: The radiocephalic arteriovenous fistula (RCAV) has been proved to be safe and effective vascular access for chronic hemodialysis. The incidence of fistula failure or complications is extremely low. The purpose of this study was to compare the effectiveness and complication rates between the original technique of radiocephalic arteriovenous fistula and the Pongsapak modified technique.
Materials and Methods: Radiocephalic arteriovenous fistulas were performed in 80 patients with chronic renal failure at Phrae Hospital from January 2002 to October 2005. Half of them (40/80) were performed using the original technique and the other half (40/80) with the Pongsapak modified technique. Demographic data, blood flow rate, duration of function, thrombotic complications, infection rates, number of operations and cost were analysed.
Results: The data were analyzed and compared using Mann-Whitney U test for two independent groups. The results of this study revealed that the Pongsapak modified technique was more effective with fewer complications compared with the original technique (P<.01). This modified technique gave satisfactory results not only by increasing the size of the fistula but also by decreasing visible scar by S-plasty incision at the wrist. Once established, the incidence of fistula failure and thrombosis has been extremely low and the incisional scar is less perceptible.
Conclusions: The Pongsapak modified technique of arteriovenous fistula at the wrist has proved to be a safe and effective means of gaining vascular access for chronic hemodialysis. The technique was well accepted by patients, physicians and dialysis personnel. The author recommends the use of Pongsapak modified technique for the creation of radiocephalic AV fistulas for long-term hemodialysis.
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