| Summary: | Background: The basilic vein is a deep vein which usually requires superficialisation and surgical transposition. Material and methods: This is a retrospective study of 119 BBAVF-ST in patients with stage 5D chronic kidney disease who received an implant with a one-stage surgical technique (2011–2015). The percentage of primary (PP), assisted primary (APP) and secondary (SP) permeabilities were assessed, as well as the related complications. We analyzed the permeabilities using Kaplan–Meier survival curves and a univariate Log Rank analysis (Mantel–Cox). p values less than or equal to 0.05 were considered as significant. Results: The mean age of the study group was 67.9 years, with 63.8% of the subjects being male. A total of 57 complications were detected during the follow-up period: 24 stenosis (42.1%), 11 thrombosis (19.2%), 7 vascular access steal syndromes (12.2%), 7 upper limb oedemas (12.2%), 6 post-puncture haematomas (10.5%) and 2 infections (3.5%). The percentages of PP obtained at 1, 6, 12 and 24 months were 92.4%, 79.8%, 66.3% and 52%; APP: 94.1%, 87.3%, 80.4% and 65.6%, and SP: 95%, 89.1%, 84% and 67.5%, respectively. Diabetic patients presented with significantly worse permeabilities than vascular or idiopathic patients: (p = .037, .009 and .019, respectively). Conclusions: According to the results obtained in our study, the one-stage surgical implementation of BBAVF-ST presents high permeability rates and a small number of related complications. Diabetes mellitus is a factor related to a worse surgical prognosis. Some of the biggest advantages are the greater optimization of health resources and a shorter time in which the central venous catheter needs to remain in the body. Resumen: Introducción: La vena basílica se caracteriza por ser un vaso profundo que en la mayoría de los casos requiere superficialización y trasposición quirúrgica. Material y métodos: Estudio retrospectivo de 119 FAVn HB S-T en pacientes con insuficiencia renal crónica 5D implantadas en un solo acto quirúrgico (2011-2015). Se analiza el porcentaje de permeabilidades primaria (PP), primaria asistida (PPA) y secundaria (PS), así como las complicaciones asociadas. Análisis de permeabilidades mediante curvas de supervivencia Kaplan-Meier y análisis univariante mediante Log Rank (Mantel-Cox). Se considera significativa una p ≤ 0,05. Resultados: Edad media 67,9 años y 63,8% hombres. Durante el período de seguimiento se objetivaron un total de 57 complicaciones: 24 estenosis (42,1%), 11 trombosis (19,2%), 7 síndromes de robo vascular (12,2%), 7 edemas de extremidad superior (12,2%), 6 hematomas pospunción (10,5%) y 2 infecciones (3,5%). Los porcentajes de PP obtenidos a 1, 6, 12 y 24 meses: 92,4, 79,8, 66,3 y 52; PPA: 94,1, 87,3, 80,4 y 65,6%, y PS: 95, 89,1, 84 y 67,5%. Se constataron diferencias significativas en las curvas de PP, PPA y PS según la etiología, presentando peores permeabilidades los diabéticos respecto a la vascular e idiopática (p = 0,037, 0,009 y 0,019). Conclusiones: La implantación quirúrgica de FAVn HB S-T en un solo acto ofrece buenas tasas de permeabilidad y escaso número de complicaciones asociadas. La diabetes mellitus representa un factor de peor pronóstico quirúrgico. Entre las mayores ventajas destacan una mejor optimización de los recursos sanitarios y menor tiempo de permanencia del catéter venoso central. Keywords: Haemodialysis, Vascular access, Basilic-humeral arteriovenous fistula, Single-stage surgical technique, Palabras clave: Hemodiálisis, Acceso vascular, Fístula arteriovenosa nativa humerobasílica, Un solo acto quirúrgico
|
|---|
