Nihon Toseki Igakkai Zasshi
Online ISSN : 1883-082X
Print ISSN : 1340-3451
ISSN-L : 1340-3451
Management and treatment results of ulnobasilic arteriovenous fistula by percutaneous transluminal angioplasty
Takayuki MiyagawaKazuyoshi KubotaTsutomu AraseAkira InoueYoshinori ShimizuYouji ItouMitsuo Kusano
Author information
Keywords: PTA
JOURNAL FREE ACCESS

2006 Volume 39 Issue 10 Pages 1475-1480

Details
Abstract

Guidelines for vascular access were published by the Japanese Society for Dialysis Therapy in September 2005. We have constructed vascular access for chronic hemodialysis following the proposals in this guideline. analyzed the construction of ulnobasilic arteriovenous fistulas before we shifted the construction of fistulas from the forearm to the elbow, thereafter we evaluated the cumulative patency rates of fistula and the management. For 10 years from January 1995 to December 2004, 167 cases of arteriovenous fistulas in 115 patients were constructed using either the ulnar artery and basilic vein or the radial artery and cephalic vein in the distal forearm. All cases were classified into the following two groups, group U (41 cases in 25 patients): ulnaris (ulnobasilic arteriovenous fustula) or group (126 cases in 90 patients): radialis (radiocephalic arteriovenous fistula). The age at first construction of fistula, duration of hemodialysis and cumulative primary and secondary patency rates of fistula by percutaneous transluminal angioplast (PTA) were analyzed. The age at first construction of fistula was slightly higher in group than in group R, and the duration of hemodialysis was longer in group U than in group R. Moreover, the primary patency rate of the fistula in group U was worse than that in group R. In 86 (73 patients) of 167 (115 patients), repeated PTA procedures were performed. They were classified into the two subgroups, subgroup U' (21 cases in 17 patients): ulnaris and subgroup R' (65 cases in 56 patients): radialis. Cumulative secondary patency rate of the fistula was improved in all 86 repeat cases and there was no significant difference of cumulative secondary patency rates of fistulas between subgroup U' and subgroup R'. There was a correlation between the frequency of PTA and the secondary patency rate. The interval until repeat PTA was 2.55 months in subgroup U' and 3.28 months in subgroup R', respectively. Therefore, PTA attempts were more frequent in subgroup U' and the intervals were shorter in subgroup U'. These findings suggest that repeated PTA procedures ameliorate the secondary patency rate in cases of ulnobasilic arteriovenous fistula. As a result, the secondary patency rate of the ulnobasilic arteriovenous fistula is equal to that of riocehlic arteriovenous fistula. In conclusion, we do recommend the construction of an ulnobasilic arteriovenous fistula at the forearm before fistula construction is shifted from the forearm to the elbow.

Content from these authors
© The Japanese Society for Dialysis Therapy
Previous article Next article
feedback
Top