[Evaluation of efficacy and complications of snuff box arterivenous fistulas in patients with chronic renal failure: ligation versus not ligation of distal vein]

ABSTRACT

Endogen arteriovenous fistulas [AVFs] are one of important hemodialysis access. According to current use of this technique, especially snuff box AVF, we compared the efficacy and complications of the two main techniques of snuff box AVFs, including with distal vein ligation and without ligation the vein. This double blind clinical trial was performed on 110 [11 to 83 years old] chronic renal failure [CRF] patients without evidence of proximal vein stenosis. Case and control group were matched regarding in age, sex, underlying disease and history of previous AVF. Vein distal to the site of AVF was ligated in case group and left open in control group. Patients were followed up in the days 1, 30, and 180 after the surgery to evaluate the efficacy and complications of two techniques. Short-term efficacy was 90% and 93.6% in case and control groups, respectively. Long-term efficacy was 90% in case group and 84.8% in control group [NS]. The most common complication in both groups was thrombosis followed by edema of the limb and venous hypertension. Venous hypertension was seen only in the control group [NS]. There are no statistical significant differences between two groups in efficacy and complications. Venous hypertension did not occur in any of the patients in case group. So, we recommend distal ligation of vein in snuff box AVFs