DENIZ DEMIR1, ALI TOSUN2, NAIL KAHRAMAN1, KADIR KAAN ÖZSIN1, UMUT SERHAT SANRI1, AYDEMIR KOÇASLAN3, UFUK TURAN KORKMAZ4, MEHMET TUĞRUL GÖNCÜ1
1Bursa Yüksek İhtisas Training and Research Hospital Cardiovasculary Surgery, Department, Surgeon1, Bursa, Turkey - 2Şanliurfa Mehmet Akif İnan State Hospital Radiology Department, Radiologist 2, Şanliurfa, Turkey - 3Harran University Cardiovasculary Surgery Department, Surgeon3, Şanliurfa, Turkey - 4Abant İzzet Baysal University Cardiovasculary Surgery Department, Surgeon 4, Bolu,Turkey
Introduction: An arteriovenous fistula with a high-flow rate adversely affects the hemodialysis treatment of the patients. There are several methods that help to decrease the high-flow rate. This study aims to investigate the effects of circular narrowing techni- que on lowering the flow rate with a polytetrafluoroethylene graft for the treatment of patients with a high-flow arteriovenous fistula and to present our shortand mid-term results.
Materials and methods: Seven patients with a fistula flow rate of above 1200 ml/min were retrospectively analyzed. All patients were operated on under local anesthesia and underwent a circular narrowing procedure with a polytetrafluoroethylene graft. Additional aneurysmectomy was performed on the patients with aneurysms. Fistula flow rates were recorded at baseline and following the procedure.
Results: Postoperative thrill was observed in all patients. The mean preoperative flow rate of arteriovenous fistula was 1428±230 ml/min. At three to six months following the procedure, it was 655±98 ml/min. Two patients suffered from pain in the arm at rest preoperatively and the pain resolved postoperatively. All patients continued to receive hemodialysis through the native fistula on a regular basis in the postoperative period.
Conclusion: Our study results suggest that the circular narrowing technique with a polytetrafluoroethylene graft is an effective modality that can be easily used in patients with high-flow arteriovenous fistulas.
High-flow rate, flow reduction, arteriovenous fistula, circular narrowing technique, polytetrafluoroethylene graft