Comparative study of the effects of two suturing techniques of End-to-side arteriovenous anastomosis on early outcomes of radio-cephalic fistulas
Introduction: Radiocephalic arteriovenous fistulas (AVFs) for dialysis have significantly high maturation failure rate. Many surgical technique-related factors are known to impact the outcomes of AVF surgery; anastomotic suturing technique is one such factor for which the published data is sparse. P...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Indian Journal of Vascular and Endovascular Surgery |
| Subjects: | |
| Online Access: | http://www.indjvascsurg.org/article.asp?issn=0972-0820;year=2021;volume=8;issue=6;spage=130;epage=136;aulast=Vyahalkar |
| _version_ | 1818085353008922624 |
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| author | Sameer Vilas Vyahalkar Avinash E Chaudhari Pooja G Binnani Amar Vilas Kulkarni Amit Prakash Nagarik Kailash K Jawade Shantanu S Chandrashekhar |
| author_facet | Sameer Vilas Vyahalkar Avinash E Chaudhari Pooja G Binnani Amar Vilas Kulkarni Amit Prakash Nagarik Kailash K Jawade Shantanu S Chandrashekhar |
| author_sort | Sameer Vilas Vyahalkar |
| collection | DOAJ |
| description | Introduction: Radiocephalic arteriovenous fistulas (AVFs) for dialysis have significantly high maturation failure rate. Many surgical technique-related factors are known to impact the outcomes of AVF surgery; anastomotic suturing technique is one such factor for which the published data is sparse. Patients and Methods: We retrospectively analyzed the data of patients who underwent end-to-side radio-cephalic AVF surgery during a 2-year period and grouped it according to the two techniques of anastomotic suturing: Anchor technique and parachute technique. Comparative analysis was done to study the effect of the technique on well-defined outcomes within the first 6 months of surgery. Results: A total of 119 AVFs (anchor technique = 65, parachute technique = 54) were included in the study. The aggregated primary patency at 6 weeks and 6 months was 85.7% and 78.1% respectively and successful use of fistula was seen in 62.2%. The parachute technique was associated with lower immediate access thrombosis (3.7% vs. 15.4%, P = 0.019) and primary failure (31.5% vs. 43%, P = 0.033) than the anchor technique. The groups did not differ statistically in outcomes like early access failure (P = 0.376), maturation failure (P = 0.105), primary patency at 6 weeks (P = 0.07) and at 6 months (P = 0.083) and successful use of fistula at 6 months (P = 0.196). Conclusion: In this retrospective single-center study, the parachute technique of anastomotic suturing was associated with lower incidence of immediate access failure of radio-cephalic AVF as compared to the anchor technique, although other early outcomes were similar with both techniques. The effects of different suturing techniques on surgical outcomes of AVF should be studied in large randomized trials. |
| first_indexed | 2024-12-10T20:08:26Z |
| format | Article |
| id | doaj.art-415cfc9e6c104b54a3074f656a94bd6f |
| institution | Directory Open Access Journal |
| issn | 0972-0820 2394-0999 |
| language | English |
| last_indexed | 2024-12-10T20:08:26Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Vascular and Endovascular Surgery |
| spelling | doaj.art-415cfc9e6c104b54a3074f656a94bd6f2022-12-22T01:35:20ZengWolters Kluwer Medknow PublicationsIndian Journal of Vascular and Endovascular Surgery0972-08202394-09992021-01-018613013610.4103/ijves.ijves_58_21Comparative study of the effects of two suturing techniques of End-to-side arteriovenous anastomosis on early outcomes of radio-cephalic fistulasSameer Vilas VyahalkarAvinash E ChaudhariPooja G BinnaniAmar Vilas KulkarniAmit Prakash NagarikKailash K JawadeShantanu S ChandrashekharIntroduction: Radiocephalic arteriovenous fistulas (AVFs) for dialysis have significantly high maturation failure rate. Many surgical technique-related factors are known to impact the outcomes of AVF surgery; anastomotic suturing technique is one such factor for which the published data is sparse. Patients and Methods: We retrospectively analyzed the data of patients who underwent end-to-side radio-cephalic AVF surgery during a 2-year period and grouped it according to the two techniques of anastomotic suturing: Anchor technique and parachute technique. Comparative analysis was done to study the effect of the technique on well-defined outcomes within the first 6 months of surgery. Results: A total of 119 AVFs (anchor technique = 65, parachute technique = 54) were included in the study. The aggregated primary patency at 6 weeks and 6 months was 85.7% and 78.1% respectively and successful use of fistula was seen in 62.2%. The parachute technique was associated with lower immediate access thrombosis (3.7% vs. 15.4%, P = 0.019) and primary failure (31.5% vs. 43%, P = 0.033) than the anchor technique. The groups did not differ statistically in outcomes like early access failure (P = 0.376), maturation failure (P = 0.105), primary patency at 6 weeks (P = 0.07) and at 6 months (P = 0.083) and successful use of fistula at 6 months (P = 0.196). Conclusion: In this retrospective single-center study, the parachute technique of anastomotic suturing was associated with lower incidence of immediate access failure of radio-cephalic AVF as compared to the anchor technique, although other early outcomes were similar with both techniques. The effects of different suturing techniques on surgical outcomes of AVF should be studied in large randomized trials.http://www.indjvascsurg.org/article.asp?issn=0972-0820;year=2021;volume=8;issue=6;spage=130;epage=136;aulast=Vyahalkarearly outcomesend-to-side anastomosisradiocephalic arteriovenous fistula |
| spellingShingle | Sameer Vilas Vyahalkar Avinash E Chaudhari Pooja G Binnani Amar Vilas Kulkarni Amit Prakash Nagarik Kailash K Jawade Shantanu S Chandrashekhar Comparative study of the effects of two suturing techniques of End-to-side arteriovenous anastomosis on early outcomes of radio-cephalic fistulas Indian Journal of Vascular and Endovascular Surgery early outcomes end-to-side anastomosis radiocephalic arteriovenous fistula |
| title | Comparative study of the effects of two suturing techniques of End-to-side arteriovenous anastomosis on early outcomes of radio-cephalic fistulas |
| title_full | Comparative study of the effects of two suturing techniques of End-to-side arteriovenous anastomosis on early outcomes of radio-cephalic fistulas |
| title_fullStr | Comparative study of the effects of two suturing techniques of End-to-side arteriovenous anastomosis on early outcomes of radio-cephalic fistulas |
| title_full_unstemmed | Comparative study of the effects of two suturing techniques of End-to-side arteriovenous anastomosis on early outcomes of radio-cephalic fistulas |
| title_short | Comparative study of the effects of two suturing techniques of End-to-side arteriovenous anastomosis on early outcomes of radio-cephalic fistulas |
| title_sort | comparative study of the effects of two suturing techniques of end to side arteriovenous anastomosis on early outcomes of radio cephalic fistulas |
| topic | early outcomes end-to-side anastomosis radiocephalic arteriovenous fistula |
| url | http://www.indjvascsurg.org/article.asp?issn=0972-0820;year=2021;volume=8;issue=6;spage=130;epage=136;aulast=Vyahalkar |
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