Sands JJ, Miranda CL
Increasing AV fistulas for hemodialysis access
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Nov) 6:501 1995
We all know that fistulas last longer than grafts, and that there
is a trend to use more synthetic grafts in the United States. So
the logical question to ask is, what happens if we deliberately
increase the use of grafts? Sands et al give only part of the
answer in this study, where, under a CQI program, they increased
the % fistulas in initial access insertions from 38% to 73% over
a 2 yeasr period. 86% of initial fistulas were useable, due
largely to a high and increasing use of brachial artery fistulas.
Comment: This paper shows it can be done, but
there are no outcome data to show that this approach actually
reduces the incidence of access thrombosis or other
complications.
(Daugirdas)
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Am Soc Nephrol
Basic hemodialysis :
Vascular Access: graft/fistula