Novosti
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This journal is indexed in Scopus |
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Year 2014 Vol. 22 No 2
GENERAL AND SPECIAL SURGERY
A.N. POPOV 1, B.A.VESELOV 1, R.R. FASKHIEV1, E.P. BURLEVA2, A.V. NAZAROV1
BRACHIAL-SUBCLAVIAN FISTULA AS VASCULAR ACCESS CHOICE IN PROBLEMATIC PATIENTS ON CHRONIC HEMODIALYSIS
Municipal Autonomic Establishment “City Clinical Hospital №40” 1,
SBEE HPE “Ural State Medical University” 2,
Yekaterinburg,
The Russian Federation
Objectives. To determine the structure of complications and functioning time of the brachial - subclavian fistula (BSF).
Methods. During the period from September 2002 to June 2012 23 patients with the end-stage renal disease (ESRD) underwent 25 BSF with polytetrafluoroethylene (two patients twice). The age of patients ranged from 30 to 74 years (M=52 years), there were 15 women, 10 men. The stay duration on chronic hemodialysis before the formation of the fistula ranged from 1 to 132 months (M=44 months). Over the ten-year follow-up period, the complications were analyzed, and the calculation of the cumulative five-year BSF patency using the Kaplan-Meier method was performed.
Results. Totally, 37 complications were registered. The most frequent complication during the use of arteriovenous fistula (AVF) was thought to be thrombosis – in 28 cases. 27 patients underwent thrombectomy and 1 patient – systemic thrombolysis (with thrombolytic drug Actilyse). The maximal number of thrombosis was registered during the first two years – 21 cases (75%), at present 17 (81%) of AVF have been restored. Four aneurysmal resections were performed (n=4). 2 surgeries were performed in patients with infected prosthesis and 2 more operations – the excision of cutaneous fistulas in the projection of BSF without local infection. The BSF cumulative patency through 62 months of follow-up was 48.02% with a standard error – 14,13%.
Conclusions. Formation of the brachial-subclavian fistula from PTFE clarifies acceptable medical options for problematic patients on chronic hemodialysis.
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620102, g. Ekaterinburg, ul. Volgogradskaia, 189, MAU «Gorodskaia klinicheskaia bol'nitsa №40», otdelenie sosudistoi khirurgii,
e-mail: burleva@gkb40.ur.ru,
Burleva Elena Pavlovna
Popov A.N. A cardiovascular surgeon of the cardiovascular surgery unit of MAE “City Clinical Hospital №40”, Yekaterinburg.
Veselov B.A. A cardiovascular surgeon of the cardiovascular surgery unit of MAE “City Clinical Hospital №40”, Yekaterinburg.
Faskhiev R.R. A physician of functional and ultrasound diagnostics of the functional diagnostics unit of MAE “City Clinical Hospital №40”, Yekaterinburg.
Burleva E.P. MD, professor of the general surgery chair of SBEE HPE “Ural State Medical University”.
Nazarov A.V. MD, a head of the chronic dialysis and detoxification unit of MAE “City Clinical Hospital №40”, Yekaterinburg.
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