Özet:

Objective: The purpose of this study is to search for patency and complications of secondary arterio-venous fistula (AVF) creation with saphenous vein graft (SVG) in end stage renal failure (ESRF) patients whose previous upper extremity AVF"s were thrombosed. Material and Methods: From january 2006 to january 2011, secondary AVF"s created with SVG in 20 ESRF patients and scanned retrospectively . All access procedures were planned on the basis of preoperative duplex utrasonographic (USG) scans of arm and forearm veins. All of the patients had previous thrombosed upper extremity fistulas. After lower extremity venous doppler investigation SVG was used in the patients who did not have deep venous thrombosis (DVT), deep venous failure (DVF) and sapheno-femoral failure (SFF). Functional patency was defined as the ability of succesfull hemodialysis (HD). Primary and secondary cumulative functional patency of SVG were determined with Kaplan Meier test, revision rates including thrombolysis, thrombectomies and operative revisions were analyzed with the Fisher Exact T test. Results: Mean follow up was 50 months (range 49-61 months). Primary functional patency rates were 55% and 15% for 24 and 48 months respectively. Secondary functional patency rates were 70 % and 40% for 24 and 48 months respectively. There were 5 (25%) infection, 7 (35%) graft thrombosis occured. Conclusion: We conclude that secondary AVF creation with SVG is an alternative HD access method in the patient who had lost the chance of fistula creation in their upper extremities with their native vessels.

Anahtar Kelimeler: