Experience of 121 cases of revision of arteriovenous fistula

Objective To summarize the causes and approaches of revision of arteriovenous fistula(AVF) in patients undergoing maintenance hemodialysis.Methods The clinical data of 121 cases of revision of AVF were retrospectively analyzed.Results Thrombosis occurred in 108 cases,vascular stenosis in 8 cases,aneurysm in 4 cases,and fistula bleeding in 1 case.End to end anastomosis of the radial artery-cephalic vein,radial artery-basilic vein and radial artery-median vein in the forearm was carried out in 79 cases,6 cases and 1 case respectively.End to end anastomosis of the radial artery-cephalic vein,radial artery-median cubital vein and radial artery-basilic vein in the elbow was performed in 5 cases,6 cases and 1 case respectively.End to side anastomosis of the brachial artery-cephalic vein,brachial arterymedian cubital vein and brachial artery-basilic vein in the upper arm was made in 2 cases,1 case and 1 case respectively.Besides,operations were conducted in the forearm of the opposite side in 19 cases.A total of 120 cases successed to reconstruct fistula,with the success rate of 99.2%.102 cases(84.3%) successed to overhaul the AVF.86 cases(84.3%) continued to use the original vein,who could use the AVF in 24-48 hours after surgery.Conclusions Revision of AVF is a favorable emergency way to reconstruct fistula in patients undergoing maintenance hemodialysis.