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[Surgical experiences with the arteriovenous hemodialysis shunt (1970-1988)].

Authors: H, Wehrli; R, Chenevard; K, Zaruba;

[Surgical experiences with the arteriovenous hemodialysis shunt (1970-1988)].

Abstract

Data were collected concerning 307 arteriovenous fistula for hemodialysis created in 186 patients between 1970 and 1988 at the Municipal Hospital Waid of Zurich. The average age of all patients was 52.7 years. The procedure which provides access for 97.2% of all patients is the radiocephalic fistula (Cimino-Brescia), which became dilated within 4 weeks in 82.9%. There was a primary failure rate of 11.2%. The patency rate was 60.2% after 3 years and 36.6% after 5 years. Early complications, especially thrombosis, occurred in 11.2% and were caused usually by technical faults or hypotonia. Late complications were discovered in 42.8% of the patients (22.5% thrombosis, 7% stenosis, 2.1% aneurysm, 2.6% infection, 2.7% steal syndrome and 5.9% skin alterations). During the average period of dialysis (4.6 years), 38% of the patients needed more than one fistula. In that situation too, the same radiocephalic fistula was performed in the contralateral forearm (30%) prior to perform advanced procedures like PTFE-grafts (29%), etc. The patency rate after 3 years was 60.4% for radiocephalic fistula and 69.7% for PTFE transplants. The shuntthrombosis was again the main early (9.9%) and late (24%) postoperative complication. With help of a surgical thrombectomy or more conservative procedures like anticoagulation, local thrombectomy and transluminal angioplasty, 81.2%, respectively 64% of the failed fistula could be restored. Other complications like bleeding, aneurysms and infections occurred especially in arteriovenous grafts (0.5-5.7%).

Keywords

Bioprosthesis, Male, Graft Occlusion, Vascular, Middle Aged, Blood Vessel Prosthesis, Arteriovenous Shunt, Surgical, Renal Dialysis, Humans, Kidney Failure, Chronic, Female, Saphenous Vein, Polytetrafluoroethylene

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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