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Microsurgery for “wrist” arteriovenous fistula creation in children: a retrospective cohort study

Abstract

Introduction

Creating functional arteriovenous fistulae (AVF) at the wrist is challenging in paediatric patients because of the small calibre of the blood vessels.

Methods

We report our experience with AVF surgery in children younger than 15 years of age using microsurgical techniques. Twenty-five patients underwent AVF surgery between 2003 and 2015 (20 for haemodialysis, 4 for plasmapheresis and 1 for parenteral nutrition). Median (range) age was 9 (2-15) years and median weight was 24 (8-61) kg.

Results

The one-month occlusion rate was 8%. The primary and secondary patency rates at 1, 2, 3 years were: 60%, 49%, 42%, and 82%, 72%, 54%, respectively. The median (range) maturation time was 4.53 (0.5-11.2) months. We found no statistically significant effect of patient age, body weight, type of AVF and indication for AVF creation on the primary and secondary patency rates.

Conclusions

Microsurgical AVF creation at the wrist can be performed with satisfactory results and should be the preferred technique in the paediatric population.

Post author correction

Article Type: ORIGINAL RESEARCH ARTICLE

Article Subject: Dialysis

DOI:10.5301/jva.5000830

Authors

Afram Akturk, Roel Bakx, Michiel J.S. Oosterveld, Jim C.H. Wilde, Mirza M. Idu

Article History

Disclosures

Financial support: No grants or funding have been received for this study.
Conflict of interest: None of the authors has financial interest related to this study to disclose.

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Authors

Affiliations

  • Department of Vascular Surgery, Emma Children Hospital, Academic Medical Center, Amsterdam - The Netherlands
  • Department of Paediatric Surgery, Emma Children Hospital, Academic Medical Center, Amsterdam - The Netherlands
  • Paediatric Nephrology, Emma Children Hospital, Academic Medical Center, Amsterdam - The Netherlands

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