Abstract:

BACKGROUND: Internal arteriovenous fistula of cephalic vein and radial artery in forearm is a necessary vascular access in hemodialysis before kidney transplantation.
OBJECTIVE: To compare the clinical effect between anatomical snuffbox and forearm internal arteriovenous fistula in hemodialysis.
METHODS: A total of 214 patients with chronic renal failure were randomly divided into snuffbox (n=118) and forearm internal arteriovenous fistula (n=96) groups, respectively underwent internal arteriovenous fistula at anatomical snuffbox and distal forearm. Success rate of operation, time of maturation, volume of blood flow, patency rate of short-term and long-term, and complications in two groups were observed and compared.
RESULTS AND CONCLUSION: There were no significant differences between two groups in success rate of operation, time of mature, and volume of blood flow (P > 0.05). The patency rates in snuffbox and forearm groups were similar in short-term periods, but the patency rate was significantly greater in snuffbox group than forearm group at 2-3 years (P < 0.05), and the incidence rates of pseudoaneurysm and congestive heart failure in snuffbox group were significantly less than the forearm group (P < 0.05). Moreover, there were no significant differences in incidence rates of symptom swelling syndrome and steal syndrome between two groups (P > 0.05). Compared with forearm internal arteriovenous fistula, anatomical snuffbox internal arteriovenous fistula should be the first-chosen permanent vascular access in hemodialysis due to easier establishment, higher long-term patency rates, fewer complications and longer service life.