Scientific Articles
Transposed brachio-basilic arterio-venous fistulae versus prosthetic arteriovenous grafts; mid-term results and a review of literature.
This article was retracted on 31st August 2019
Authors:
Nalaka Gunawansa ,
National Institute of Nephrology Dialysis and Transplant, LK
About Nalaka
University of Edinburgh, United Kingdom
Bernhard Wolf
University of Edinburgh, GB
About Bernhard
Raigmore Hospital, Inverness, United Kingdom
Abstract
Introduction
With increasing prevalence of chronic kidney disease worldwide, the demand for long-term renal replacement therapy is on the incline. Apart from renal transplantation, this includes sustainable vascular access for long-term haemodialysis, often requiring secondary and tertiary access.
Objective
To assess the place of Transposed Brachio-Basilic Arterio- Venous Fistula (TBB-AVF) as a second line access compared to prosthetic Aretrio Venous Grafts (AVG), with emphasis on functional patency and access related morbidity and mortality.
Study Design
A prospective cohort study (January 2014 to March 2016) comparing TBB-AVF and AVG, at the National Institute of Nephrology Dialysis and Transplantation, Colombo, Sri Lanka.
All patients where venous mapping revealed no suitable cephalic vein were included. Those who preferentially opted for a central venous catheter, those requiring urgent initiation of dialysis or considered unfit for TBB-AVF or AVG creation were excluded. TBB-AVF was performed where the basilica vein was patent and >2 mm. AVG was used when it was <2mm or when haemodialysis was expected to commence within 4 weeks.
Results
459 patients were enrolled; 382(83%) TBB-AVF and 77(17%) AVG. Mean follow-up was 11(± 4.8) months. There were 9 deaths, all >4 weeks from access creation and not directly related to the access. The all-cause mortality rate was 5/382 (1.3%) TBB-AVF and 4/77 (5.2%) AVG; p=0.02. Surgical site infections were seen in 24 (6.4%) TBB-AVFs and 10 (13.7%) AVGs; p=0.03. The overall functional patency at six months was 307/375 (81.9%) in TBB-AVF and 57/73 (78.1%) in AVGs; p=0.45.
Conclusion
TBB-AVF provide comparable medium term functional patency to AVG and are associated with a significantly less incidence of all-cause mortality and surgical site infection.
How to Cite:
Gunawansa N, Wolf B. Transposed brachio-basilic arterio-venous fistulae versus prosthetic arteriovenous grafts; mid-term results and a review of literature.
This article was retracted on 31st August 2019
. Sri Lanka Journal of Surgery. 2017;35(2):7–15. DOI: http://doi.org/10.4038/sljs.v35i2.8382
Published on
31 Aug 2017.
Peer Reviewed
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