Outcome of end to side and side to side arteriovenous anastomosis in creating radiocephalic fistula of patients suffering from end stage renal disease

Abstract

A radiocephalic arteriovenous fistula (AVF) is the preferred access method for hemodialysis (HD). The End-to-Side (ETS) anastomosis technique has been suggested to yield better outcomes compared to the Side-to-Side (STS) approach; however, there is limited evidence directly comparing the two methods. Given this, the present study aimed to evaluate and compare the outcomes of ETS and STS techniques in creating radiocephalic fistulas for end-stage renal disease (ESRD) patients. This quasi-experimental study was conducted in the Department of Urology at Sir Salimullah Medical College Mitford Hospital, Dhaka, over a 12-month period (May 2022 to April 2023) following ethical approval. A total of 74 ESRD patients requiring permanent vascular access for maintenance HD were enrolled, with 37 patients undergoing ETS AVF (Group A) and 37 patients receiving STS AVF (Group B). Postoperative follow-ups were conducted on the third day, as well as at the 6th and 12th weeks, using clinical evaluations, patient history, and investigations. Data were collected using structured case record forms and analyzed using SPSS 24.0. Baseline characteristics such as age, sex, and comorbidities were similar between the two groups. At the 6th week, maturation was observed in 78.4% of Group A patients compared to 48.6% in Group B, with the difference being statistically significant (p