Feasibility of creating autologous radiocephalic fistulas using thrombosed/stenotic cephalic veins.

OBJECTIVE

To explore the feasibility of establishing arteriovenous fistulas (AVFs) using thrombosed/stenotic cephalic veins in hemodialysis patients.

METHODS

For 27 patients with good vascular conditions but thrombosis and/or stenosis in the cephalic vein, the lesions were relieved by thrombectomy and/or percutaneous transluminal angioplasty (PTA), and radiocephalic AVFs were created. These patients composed the intervention group. A control group (n = 108) of patients with newly created AVFs was obtained via the propensity score matching method. The patients were followed up to observe the maturation and patency rates of AVFs.

RESULTS

In the intervention group, 25 patients (92.59%) achieved AVF maturation. The primary patency rates at 3, 6, 9, and 12 months were 95.8%, 87.5%, 83.3%, and 74.5%, respectively. The secondary patency rate remained at 95.8% after 6 months. In the control group, 85 patients (78.70%) achieved AVF maturation. The primary patency rates at 3, 6, 9, and 12 months were 98.8%, 91.3%, 76.1%, and 67.2%, respectively. The secondary patency rates at 12, 24, and 36 months were 92.3%, 89.4%, and 83.0%, respectively. No significant differences were observed in the AVF maturation rates or primary/secondary patency rates between the two groups (p > 0.05). Cox regression analysis also revealed that the decrease in primary or secondary patency did not significantly differ between the two groups (p = 0.60 and p = 0.21, respectively).

CONCLUSION

Thrombosed/stenotic cephalic veins can be used for AVF creation as long as the lesions can be relieved during the perioperative period.