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Year : 2021  |  Volume : 10  |  Issue : 1  |  Page : 132-137

Comparison of distal radiocephalic fistula vs proximal radiocephalic fistula

Department of Plastic Surgery, M.K.C.G Medical College, Berhampur, Odisha, India

Correspondence Address:
Dr. Biswajit Mishra
Department of Plastic Surgery, M.K.C.G Medical College, Berhampur-760 004, Odisha
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jfmpc.jfmpc_1232_20

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Background: Distal radiocephalic fistula (DRCF) at wrist is the first option of vascular access in patients undergoing hemodialysis. In patients with a failed DRCF or unsuitable for DRCF the current recommendation is to perform a brachiocephalic fistula. Proximal forearm radiocephalic fistulas (PRCF) are created less frequently. The aim of the present study was to evaluate the outcomes of PRCF and DRCF. Material and Methods: A longitudinal study was conducted in the department of MKCG Medical College from January 2018 to July 2019. Data was collected and entered in Microsoft excel. The analysis was done by R version 3.6.1. Quantitative data were presented in the form of Mean and SD and were tested by unpaired t-test. Categorical data were presented as count and proportion and was tested by Chi-square test or if applicable Fischer's exact test. Comparison between two procedures was done by Kaplan-Meier method and evaluated by the log-rank test. With the 95% of Level of significance, P value <0.05 was consider statistically significant during analysis. Results: The demographic data of the two patient groups were similar except that those with PRCF were more likely to have had a previous access and caliber of distal vessel was less. Early failure was lower for PRCF than DRCF (6.06% vs 15%). Primary patency rate at one year was 87.87% in PRCF vs 70% in DRCF. Conclusion: A PRCF can be a suitable alternative to a brachiocephalic fistula in patients who cannot receive a DRCF.

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