Loup-assisted technique to create arterio-venous fistulas in elderly. A single centre experience

doi: 10.7417/CT.2019.2175

  • V. D. Palumbo Department of Surgical and Stomatological Disciplines, University of Palermo - Euro-Mediterranean Institute of Science and Technology (IEMEST), Palermo
  • S. Fazzotta Department of Surgical and Stomatological Disciplines, University of Palermo
  • G. Damiano Department of Surgical and Stomatological Disciplines, University of Palermo
  • M. C. Gioviale Department of Surgical and Stomatological Disciplines, University of Palermo
  • C. Maione “P. Giaccone” University Hospital, Palermo, Italy
  • A. Maffongelli Department of Surgical and Stomatological Disciplines, University of Palermo
  • A. I. Lo Monte Department of Surgical and Stomatological Disciplines, University of Palermo - “P. Giaccone” University Hospital, Palermo, Italy

Abstract

Aims
The radio-cephalic arteriovenous fistula (RCAVF) is the first choice treatment in end-stage renal disease patients. In the last few years, the hemodialysis population has shown a high  percentage of elderly patients (> 65 year old) with comorbidities, mainly vascular diseases, which may adversely affect their vascular access success. The aim of this study was to evaluate the effectiveness of a loup-assisted technique to create RCAVFs in over 65 patients.


Patients and Methods
98 consecutive patients with renal failure were prospectively observed. The patient were divided in relation to their age (> 65 year old; < 65 year old). In both groups, a microsurgical distal RCAVF was created. Statistics included the prevalence of distal RCAVF created, the incidence of immediate failure, the primary and secondary patency rate at one year.


Results
Distal RCAVF was created in 82.60% of patients younger than 65 years and in 73.07% of patients older than 65 years, with no statistically significant difference. The incidence of immediate failure, the primary and secondary patency at one year were not statistically significant between the two groups.


Conclusions
Distal RCAVF should be the first choice vascular access even in ESRD elderly patients. The loup-assisted microsurgical fistula creation, allows to perform distal RCAVF with success, even in patients older than 65 years old, achieving similar results to younger patients

Published
2019-11-06
How to Cite
PALUMBO, V. D. et al. Loup-assisted technique to create arterio-venous fistulas in elderly. A single centre experience. La Clinica Terapeutica, [S.l.], v. 170, n. 6, p. e454 - e459, nov. 2019. ISSN 1972-6007. Available at: <http://www.clinicaterapeutica.it/ojs/index.php/ClinicaTerapeutica/article/view/526>. Date accessed: 15 nov. 2019.