[Operative outcome and experience in arteriovenous shunt at different sites].

OBJECTIVE: To summarize and analyze the influencing factors of both success and half-year patency rate of radial artery-cephalic vein arteriovenous fistula. METHODS: A retrospective analysis was made on the clinical data of 102 patients with chronic renal failure undergoing radial artery-cephalic vein arteriovenous shunt for hemodialysis during 7 years and the influence of different factors: sex, age, primary disease, incision site, and situations of vessels on the operative success rate and the half-year patency rate of the fistula was compared. RESULTS: No significant difference in the initial success rate of operation was found between the operations performed at the two different incision sites: at the wrist and at anatomist's snuffbox. However, the operation at the wrist was better than that at anatomist's snuffbox with regard to the half-year patency rate. Both operative success rate and half-year patency rate were not influenced by patient's sex, age, and primary disease. Anastomotic hyperplasia, condition of blood vessel and anastomotic technique were important factors influencing the operative failure and fistula occlusion. CONCLUSION: Correct selection of incision site is of key importance for both operative success and maintenance of half-year patency of radial artery-cephalic vein arteriovenous fistula. In addition, anastomotic hyperplasia, diameter and intimal smoothness of selected blood vessel, condition of run-off vessel, operative technique, anastomotic angle, distance between artery and vein, and patient's self-protection are also considered important influencing factors.