A prospective study of end-to-side vs. side-to-side arteriovenous fistulas for haemodialysis

Br J Surg. 1984 Aug;71(8):640-2. doi: 10.1002/bjs.1800710831.

Abstract

In an attempt to determine the optimum configuration of arteriovenous (A-V) fistulas for haemodialysis, 71 patients were prospectively randomized to undergo either a side-to-side or end-of-vein to side-of-artery A-V fistula. Nine months after operation, the patency rates on dialysis were almost identical in the two groups (79.2 per cent and 78.6 per cent respectively). However, 7 of the 32 side-to-side fistulas developed hyperaemia of the hand, three of which required revisional surgery. Hyperaemia of the hand has not been seen with end-to-side fistulas. In addition, peroperative measurements of fistula flow appeared to have prognostic value with end-to-side but not with side-to-side fistulas. It is suggested that the end-to-side configuration is the one of choice for the formation of A-V fistulas for haemodialysis.

Publication types

  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Arteriovenous Shunt, Surgical / methods*
  • Blood Flow Velocity
  • Blood Pressure
  • Female
  • Humans
  • Intraoperative Period
  • Male
  • Postoperative Complications
  • Postoperative Period
  • Prospective Studies
  • Random Allocation
  • Regional Blood Flow
  • Renal Dialysis*
  • Thrombosis / etiology
  • Wrist / blood supply