Abstract
Background and Objectives: Arteriovenous fistula is a common vascular access for hemodialysis. There are various ways to make a fistula, like side to side anastomosis in antecubital region. The aim of current study is to evaluate the efficacy and complications of distal vein ligation versus not ligation during side to side antecubital arteriovenous fistulas in patients with chronic renal failure.
Materials and Methods: In this randomized controlled clinical trial, 63 patients with renal failure underwent arteriovenous fistula (AVF) surgery. In first group (n=30) after AVF creation, distal vein was ligated and in second group (n=33) the distal was left open. The percentage of AVF function venous hypertension and steal syndrome were evaluated in all patients in first and sixty day after the surgery.
Results: The percentage of functioning fistula was 86.7% in those with distal ligation and 81.8% in those without distal ligation (P>0.05). There was no difference between these two groups according to proximal vein flow and blood velocity in fistula mild. Venous hypertension in those with and without distal vein ligation were 23.3% and 42.4%, respectively. Moderate venous hypertension was detected in 3.3% and 6.1% (p=0.20). Steal syndrome in groups with and without distal venous ligation happened correspondingly in 6.7% and 9.1% (p=0.90).
Conclusion: Although venous hypertension and steal syndrome was lower and AVF function was higher in those with distal vein legation, there was no significant difference between these two methods both in their side effect and their patency rate.