Dr. K K Sahu, Dr. N Chandel



            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.


            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.



            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.


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


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

Full Text:



Ziabakhsh Tabary SH, Fazli M. Clinical outcome of coronary artery bypass grafting (CABG) in hemodialysis dependent patients and comparison with non-renal failure patients. Eur Rev Med Pharmacol Sci 2013; 17: 2628-2631.

Ozhasenekler A, Gokhan S, Guloglu C, Orak M, Ustundag M. Benefit of hemodialysis in carbamazepine intoxications with neurological complications. Eur Rev Med Pharmacol Sci 2012; 16: 43-47.

Kadan M, Karabacak K, Kaya E, Erol G, Doganci S, Yildirim V, Demirkilic U. New probing and warm washing technique in arteriovenous fistula surgery: early results of a single center. Turk J Vasc Surg Epub Ahead of print DOI: 10.9739/ uvcd. 2015-45186.

Mozaffar M, Fallah M, Lotfollahzadeh S, Sobhiyeh MR, Gholizadeh B, Jabbehdari S, Mahdi Z. Comparison of efficacy of side to side versus end to side arteriovenous fistulae formation in chronic renal failure as a permanent hemodialysis access. Nephro urol Mon 2013; 5: 827-830.

Hong SY, Yoon YC, Cho KH, Lee YH, Han IY, Park KT, Ko SM. Clinical analysis of radio-cephalic fistula using side-to-side anastomosis with distal cephalic vein ligation. Korean J Thorac Cardio- vasc Surg 2013; 46: 439-443.

Jennings WC, Taubman KE. Alternative autogenous arteriovenous hemodialysis access options. Semin Vasc Surg 2011; 24: 72-81.

Rose DA, Sonaike E, Hughes K. Hemodialysis access. Surg Clin North Am 2013; 93: 997-1012.

Miller GA, Hwang WW. Challenges and management of high-flow arteriovenous fistulae. Semin Nephrol 2012; 32: 545-550.

Stanziale R, Lodi M, D’andrea E, Sammartino F, Di luzio V. Arteriovenous fistula: end-to-end or end- to side anastomosis? Hemodial Int 2010; 15: 100- 103.

Zibari GB, Rohr MS, Landreneau MD, Bridges RM, DeVault GA, Petty FH, et. al. Complications from permanent hemodialysis vascular access surgery. 1988; 104 (4): 681 - 6.

Chazan JA, London MR, Pono LM. Long-term survival of vascular accesses in a large chronic hemodialysis population. Nephron. 1995; 69 (3): 228 - 33.

Dixon BS, Novak L, Fangman J. Hemodialysis vascular access survival: Upper arm native arteriovenous fistula. Am J Kidney Dis. 2002; 39 (1): 92 - 101.

Sahasrabudhe P, Dighe TA, Ambekar N, Panse N, Deshpande S, Londhe S, Rathod J, Pradhan M, Vajed M. Study of efficacy and functionality of modified technique of proximal arteriovenous fistula as a vascular access for hemodialysis: A retrospective analysis of 171 cases. Med J DY Patil Vidyapeeth 2019;12:139-44.

Lee CH, Ko PJ, Liu YH, Hsieh HC, Liu HP. Brachiobasilic fistula as a secondary access procedure: An alternative to a dialysis prosthetic graft. Chang Gung Med J 2004; 27: 816 - 23.

Maya ID, O’Neal JC, Young Cj, Barker-Finkel J, Allon M. Outcomes of brachiocephalic fistulas, transposed braciobasilic fistulas and upper are grafts. Clin J Am Soc Nephrol 2009; 4: 86 - 92.

Koksoy C, Demirci RK, Balci D, Solak T, Kose SK. Brachiobasilic versus brachiocephalic arteriovenous fistula: A prospective randomised study. J Vasc Sure 2009; 49: 171 - 7.

Green KB, Silverstein RL. Hypercoagulability in cancer. Hematol Oncol Clin North Am. 1996; 10: 499 - 530.

Manne V, Vaddi SP, Reddy VB, Dayapule S. Factors influencing patency of brescia-cimino arteriovenous fistulas in hemodialysis patients. Saudi j kidney Dis Transpl. 2017; 28 (2): 313 - 17.

Farber A, Tan TW, Hu B, Dember LM, Beck GJ, Dixon BS, Dialysis access consortium (DAC) study group; dialysis access consortium DAC study group. The effect of location and configuration on forearm and upper arm hemodialysis arteriovenous grafts. J Vasc Sure. 2015; 62 (5): 1258 - 64.

Astor BC, Coresh J, Powe NR, Eustace JA, Klag MJ. Relation between gender and vascular access complications in hemodialysis patients. Am J Kidney Dis. 2000; 36 (6): 11226 - 34.

Gibson KD, Gillen DL, Caps MT, Kohler TR, Sherrard DJ, Stehman Breen CO. Vascular access survival and incidence of revision: A comparison of prosthetic grafts, simple autogenous fistulas, and venous transposition fistulas from the United States renal data system dialysis morbidity and mortality study. J Vasc Sure. 2001; 34 (4): 694 - 700.


  • There are currently no refbacks.