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Saudi Journal of Kidney Diseases and Transplantation
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ORIGINAL ARTICLE Table of Contents   
Year : 2010  |  Volume : 21  |  Issue : 2  |  Page : 258-261
Surgical revision of failing or thrombosed native arteriovenous fistulas:A single center experience

Chams Clinic, Sfax, Tunisia

Correspondence Address:
Gdoura Moncef
Avenue 7 Novembre Imm Ibn Khaldoun, E4 Sfax
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Source of Support: None, Conflict of Interest: None

PMID: 20228510

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This study reports our experience at the Chams Clinic, Sfax, Tunisia, with surgical revision of malfunctioning native arteriovenous fistula (AVF). The etiological diagnosis of in­adequate access flow was determined by physical examination and a variety of clinical and phy­siological parameters. Between 1990 and 2006, surgical revisions were performed on 471 patients (mean age 52.8 years, 285 men and 186 women). There was radio-cephalic distal AVF malfunction in 299 patients (63%); the causes of malfunction in these patients included thrombosis in 47 and juxta-anastomotic vein stenosis or occlusion in 248 patients. The initial clinical success rate of all interventions was 98%. Post-intervention primary patency by Kaplan-Meier analysis at one, two, three, four, five and 10 years was 96%, 91%, 88%, 86%, 83% and 63%. Eighty-five patients had involvement of the brachial-cephalic proximal AVF. The post-intervention patency at six months, one, two and three years was 89%, 74%, 61%, 54% in these patients. There were 87 patients with the brachial-basilic upper arm AVF. The post-intervention patency at six months, one, two and three years was 94%, 84%, 64% and 55%. In conclusion, by surgical techniques, which are often simple, excellent results were obtained, and were much better than those obtained with angioplasty.

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