Autogenous Arteriovenous Fistula: A Review

Abstract

Since the introduction of the Brescia-Cimino surgical technique as access for chronic hemodialysis patient, a lot of modification of this technique has taken place. These were aimed at improving the utilization of autogenousarteriovenous fistula (AVF) by the patients with end stage renal disease (ESRD). The initial high primary failure rates lead to identification of some demographic, co-morbidity, anatomic and surgical factors that when corrected,contributed to the improve fistula patency and maturation rate. This review stressed the need for patient education, pre- operative, intra-operative and post-operative modifiable factors that would increase the creation of autogenousarteriovenous fistula. It also stressed the value of creating brachio-cephalic AVF as the primary fistula for diabetic based on the peculiar nature of their vessels and their short life expectancy. The underlying pathological basis and management of common complications that could follow the various types of autogenous AVF is discussed. Autogenous AVF despite it constraint remains the cheapest and best vascular access for ESRD patient who require chronic hemodialysis