بررسي كارايي فيستول شرياني و ريوي صافنو فمورال جهت همودياليز در بيماران مبتلا به نارسايي مزمن كليه

EFFICACY OF SAPHENO-FEMORAL A- V FISTULA IN CRONIC RENAL FAILURE PATIENTS UNDERGOING HEMODIALYSIS

Introduction: To describe the outcome of the sapheno-femoral fistula as an alternative blood access site for maintenance hemodialysis in a prospective cohort of patients with end - stage renal failure. Methods: Twenty-two patients with vascular access failure in the arms were admitted for establishing saphenofemoral fistula as a puncture site for hemodialysis. The major saphenous vein was exposed at the junction site with femoral vein and its tributary veins were ligated . The saphenous vein was isolated and mobilized throughout the thigh and end to side anastomosis accomplished with the superficial femoral artery by a running 6-0 prolene suture after conducting the vein through a subcutaneous tunnel. Results: Failure rate of saphenofemoral fistula was 22. 7% at two years follow up. Mean ± SE survival of fistula was 16.4+/- 2.75 months. Significant survival difference wasnʹt seen between two sexes. Rate of wound infection and chronic pain of surgery site was similar( 9.1%). Conclusions: Two-year survival rate of 77% and morbidity less than 10% leads to suggestion of saphenofemoral fistula as an alternative for upper extremity fistulas in end- stage renal failure patients.