Novosti
Khirurgii
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Year 2014 Vol. 22 No 2

GENERAL AND SPECIAL SURGERY

DOI: http://dx.doi.org/10.18484/2305-0047.2014.2.179   |  

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.

Keywords: hronic hemodialysis, rteriovenous fistula, brachial - subclavian fistula, complications, arteriovenous explant, polytetrafluoroethylene
p. 179 183 of the original issue
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Address for correspondence:
620102, g. Ekaterinburg, ul. Volgogradskaia, 189, MAU Gorodskaia klinicheskaia bol'nitsa 40, otdelenie sosudistoi khirurgii,
e-mail: burleva@gkb40.ur.ru,
Burleva Elena Pavlovna
Information about the authors:
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.
Contacts | ©Vitebsk State Medical University, 2007