“Magnifying glass” for difficult radiocephalic arteriovenous fistulas

Background: Some uremic patients suffering from diabetes, atherosclerosis or simple by absent or exhausted peripheral vascular bed require bigger effort in creating arteriovenous fistula. Although it is possible to use prosthetic graft for difficult cases, the use of native vessels falls always in the respect of patient’s quality of life. A help for these cases comes from the use of a microsurgical technique for creating vascular access. Patient and Methods: For this study we evaluated the 72 patients underwent microsurgical radiocephalic fistula comparing them to a homogeneous group of 72 patients underwent traditional surgery. The patients were followed up at 1, 2 months and 1 year. Results: From comparison between the two groups our findings suggested that microsurgical radiocephalic arteriovenous fistula is more effective than traditional surgery in term of functional patency with appropriate dialysis. Conclusion: The use of microsurgical technique in our experience provides an improvement for the success of distal radiocephalic arteriovenous fistula in term of primary patency in those cases with a poor prognosis according to quality of distal native vessels.