CLINICAL OUTCOME OF END TO SIDE VERSUS SIDE TO SIDE ARTERIOVENOUS FISTULA FOR DIALYSIS ACCESS AMONG CHRONIC RENAL FAILURE PATIENTS.

Dr. K K Sahu, Dr. N Chandel

Abstract


Introduction:                  

            Arteriovenous Fistula (AVFs) is the gold standard for hemodialysis & it is the best modality for hemodialysis access. Anastomotic creation of autogenous arteriovenous fistulas can be performed in different ways; side to side (STS) or end to side (ETS). However, there is a paucity of evidence to recommend them. In this study aimed to describe clinical outcome to AVF surgery for improving early patency rates.

Objectives:

            To compare the results of both surgical techniques for creation of arteriovenous fistula (AVF); End to side (ETS) versus Side to side (STS) artery techniques.

 

Materials and Methods:

            This is prospective randomised control trial study that is going to be conducted at in department of Cardiovascular and Thorasic Surgery , pt. J. N. M. Medical college Raipur. Patients were divided into two groups according to use of End to side (ETS) & Side to side (STS) technique between May 2019 to June 2019 (2 Monhs) , with six month postoperative follow up period. Group I consisted of 25 patients with End to side & Group II consisted of 25 patients with Side to side technique. Both groups were followed for duration of 6 months to assess patency. For  evaluating the quantitive variables, t-test was used while qualitative variables were measured using the chi-square and Fisher’s exact tests.

 

Results:

            In this study were included with 25 patients in End to Side (ETS) group and 25 patients in Side to Side (STS) group. Co-morbidities was not found to be significantly associated with the both groups. There were also type of fistula was not found to be significant associated with ETS & STS groups. In the six months duration, 5 patients (20%) in the STS group and 4 patients (16%) in the ETS group experienced a non working AVF. The total failure rate was 18% and during the 6 months of follow up no significant difference was detected in the patency rate.

Conclusion:

            Similar patency rates between ETS and STS fistula configuration, however, type of fistula was not significantly associated with the STS technique.


Keywords


End to Side (ETS) technique, Side to Side (STS) technique, Co-morbidities, Arteriovenous Fistula

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References


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