Arteriovenous Fistula Surgery
Özet
Arteriovenous fistulas (AVF) serve as the most preferred vascular access method for hemodialysis in patients suffering from chronic kidney disease (CKD), offering high patient comfort, long survival times, and lower mortality and morbidity rates. To ensure a successful surgical outcome, a meticulous preoperative evaluation using color Doppler ultrasonography (DUSG) is crucial for vessel mapping and planning. Key factors determining the fistula's flow rate and long-term patency include arterial blood pressure, adequate artery and vein diameters, and proper anastomosis techniques—ideally using an end-to-side continuous suture pattern. Surgeons generally prefer local anesthesia over general or regional alternatives due to its ease of application and high tolerability, despite a higher risk of localized spasms. Postoperative care requires allowing the fistula to mature for at least four weeks before initiating cannulation to prevent early failure. Despite precise surgical execution, various early and late complications can arise, such as thrombosis, bleeding, maturation failure, aneurysms, distal steal syndrome, and infections. Ultimately, early diagnosis of these complications, combined with experienced surgical intervention and dedicated patient follow-up, is paramount to saving both the vascular access and the patient's life.
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