Mediterranean International Conference on Research in Applied Sciences, Antalya, 22-24 April 2022, Antalya, Turkey, 22 - 24 April 2022, pp.584-597
Patients with chronic renal failure are increasing dramatically around the world. These patients require long-term and regular hemodialysis treatment in order to have a good quality of life. Arteriovenous (AV) fistulas are the first choice methods for hemodialysis treatment.. In cases where superficial veins are inappropriate due to anatomical or repetitive interventions, graft procedures are applied as an alternative to AV fistulas. In this study, we presented our experience in the management of vascular access methods and complications in patients requiring hemodialysis treatment.
66 patients who applied to Haydarpaşa Numune Training and Research Hospital 1. General Surgery and Transplantation clinics between January 01, 2000 and December 31, 2002, who underwent vascular intervention for one or more hemodialysis and developed complications, were analyzed retrospectively. Evaluation of AV fistula and AV graft procedures for hemodialysis was evaluated through clinical examination, repeated visits, and telephone conversations. The number of interventions in patients with AV fistula, whether graft was applied or not, and complications after these procedures were investigated. Postoperative complications and AV fistula and graft survivals of the patients were examined and compared.
In our study, fistula and graft operations performed on 66 patients were evaluated. It was determined that a total of 145 AV fistula and 38 AV graft operations were performed in patients with complications, both to continue the hemodialysis treatment and to treat the complication. These complications were thrombus, pseudoaneurysm, steal syndrome, venous hypertension, infection, bleeding and heart failure. Thrombus was found to be the most common complication.
After AV fistula and AV graft applications, complications that threaten both the life comfort and life of the patients may develop. The main approach in the treatment of complications is to prevent complications. Patient selection, preoperative preparation and good surgery will minimize complications. In addition, close monitoring of patients and early intervention in developing complications are important details. In many complications, early intervention will delay the need for surgery for a new AVF or graft. In cases where the continuity of the AV fistula or graft cannot be ensured, it is appropriate to carefully re-evaluate the patient and then plan the intervention.
Key words: Hemodialysis, vascular access, complications