CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 9/10, October/November 2013
366
AFRICA
(3.46
±
0.2 mm) compared to group 2 (2.79
±
0.1 mm) (
p
<
0.05).
There was no significant difference in mortality rate between
the groups (6% in group 1; 4% in group 2) or mean flow rate
of BVT. Time to fistula maturation was significantly shorter in
group 1 (mean 41
±
14 days) compared to group 2 (mean 64
±
28 days) (
p
<
0.05).
The rates of postoperative complications, including infection
(12% in group 1; 10% in group 2), pseudoaneurysm (4% in
group 1; 6% in group 2), steal syndrome (8% in group 1; 6% in
group 2), and oedema (10% in group 1; 10% in group 2) were
similar, indicating no significant difference between the groups.
However, there was a significant difference between the groups
in respect of thrombosis (34% in group 1; 23% in group 2),
haemorrhage (36% in group 1; 14% in group 2) and haematoma
(17% in group 1; 6% in group 2) (
p
<
0.05).
A review of the literature revealed that infection rate was 7%
in a study conducted by Dilege
et al
.
17
and 14% in a study carried
out by Veeramanive
et al
.
18
In our study, the infection rate was 12
and 13% in groups 1 and 2, respectively.
Rivers
et al
.
19
found the rate of pseudoaneurysm to be 3%. In
our study, the rate of pseudoaneurysm was 4 and 5% in group 1
and group 2, respectively.
The rate of steal syndrome was 3.2–6.5% in published
studies.
21-23
We found that 8% of the patients in group 1 and 11%
of those in group 2 had steal syndrome, indicating a higher rate
compared to the literature. A total of 4% of the patients in group
1 and 6% of those in group 2 underwent secondary corrective
surgery due to steal syndrome, which is a limb-threatening
optimal flow rate is
≥
200 ml/min with an easy-to-use device,
providing sufficient supply in a durable and safe procedure.
13,14
For this purpose, arteries and veins of the upper limbs are mostly
used. Alternative methods can be applied for patients without
suitable veins.
15,16
In compliance with the KDOQI recommendations, BVT is the
most preferred method for fistula formation in our clinic when
autologous veins are not suitable to construct radio-cephalic
and brachio-cephalic AVF.
2,3
In our study, fistulae formed by
one- and two-stage BVT were examined in terms of patency and
complication rates.
No significant difference was found between the groups in
terms of age, gender, ESRF and the number of fistulae previously
formed. In addition, there was no significant difference in
co-morbidity or the mean diameter of the brachial artery. The
diameter of the basilic vein was significantly larger in group 1
TABLE 4.ASSISTED INTERVENTIONAL SURGERY RATES
Variables
Group 1
one-stage BVT
(n = 47)
Group 2
two-stage BVT
(n = 59)
p-value
Early (
≤
10 day) thrombosis
10 (21%)
6 (12%)
< 0.05
Bleeding
8 (17%)
3 (6%)
< 0.05
Haematoma
5 (10%)
1 (2%)
< 0.05
Late (
≥
10 day) thrombosis
9 (20%)
11 (22%)
NS
Pseudo-aneurysm
2 (4%)
3 (6%)
NS
Steal syndrome
2 (4%)
3 (6%)
NS
NS: non-significant.
TABLE 5. SECONDARY PATENCY RATES OF GROUP 1
Month
n
=
47
Function
loss
Function
loss rate
Patency
rate
Cumulative
patency rate
6
40
4
0.15
0.85
85.00
12
36
4
0.10
0.90
76.00
18
35
1
0.02
0.98
74.00
24
34
1
0.02
0.98
72.00
30
33
1
0.02
0.98
70.00
36
31
2
0.06
0.94
66.00
TABLE 6. PRIMARY PATENCY RATES OF GROUP 1
Month
n
=
47
Function
loss
Function
loss rate
Patency
rate
Cumulative
patency rate
6
39
8
0.17
0.83
83.00
12
33
6
0.15
0.85
70.00
18
32
1
0.03
0.97
68.00
24
30
2
0.06
0.94
64.00
30
28
2
0.07
0.93
60.00
36
27
1
0.03
0.97
57.00
TABLE 7. SECONDARY PATENCY RATES OF GROUP 2
Month
n
=
59
Function
loss
Function
loss rate
Patency
rate
Cumulative
patency rate
6
46
3
0.06
0.94
94.00
12
44
2
0.04
0.96
90.00
18
41
3
0.07
0.93
84.00
24
40
1
0.02
0.98
82.00
30
39
1
0.02
0.98
80.00
36
38
1
0.02
0.98
77.00
TABLE 8. PRIMARY PATENCY RATES OF GROUP 2
Month
n
=
59
Function
loss
Function
loss rate
Patency
rate
Cumulative
patency rate
6
43
6
0.12
0.88
88.00
12
41
2
0.04
0.96
84.00
18
39
2
0.05
0.95
80.00
24
36
3
0.07
0.93
73.00
30
35
1
0.03
0.97
71.00
36
34
1
0.02
0.98
69.00
Fig. 1. Secondary patency rates of the two groups.
100
80
60
40
20
0
6th
month
12th
month
18th
month
24th
month
30th
month
36th
month
Group 1 Group 2
Patency rate
Fig. 2. Primary patency rates of the two groups.
90
80
70
60
50
40
30
20
10
0
6th
month
12th
month
18th
month
24th
month
30th
month
36th
month
Group 1 Group 2
Patency rate
