ABSTRACT

Like adults, children with chronic renal failure require hemodialysis as the main treatment while waiting for renal transplantation. The success of hemodialysis depends on a good vascular route. In this prospective study, 47 vascular interventions are presented in 32 children included in a hemodialysis program.

Between January 2014 and January 2016, 47 vascular interventions were conducted in 32 children who were planned for hemodialysis. Radiocephalic fistula was performed in 11, brachiocephalic fistula in 22, and brachiobasilic fistula in 14 patients. Arteriovenous (AV) fistulas were followed-up between 3 months and 5 years (average, 18.1±14.1 months).

The functional time of fistulas was approximately 18.6±15.3 months. Five radiocephalic fistulas and two brachiocephalic fistulas were redone because of fistula thrombosis. Wound infection was observed in 1 patient who recovered with medical treatment. In 3 patients, fistula aneurysm was observed. The aneurysmal vein was ligated, and a new fistula was performed on the other arm. Congestive heart failure, neuropathy, and venous hypertension were not observed in any patient.

The results and complications of vascular intervention for hemodialysis in children are same as those in adults. If a good technique is applied in children, the functional rate of the fistula will be higher and the rate of infection and hematoma will be lower. We believe that if AV fistulas, which were performed by an experienced surgery team, are carefully followed-up using a multidisciplinary approach, and if vascular structure is used rationally, the fistulas will be functional for a longer time.