Permanent Vascular Access : 20 Year Experience in Chaoprayayomraj Hospital - Permanent Vascular Access : ประสบการณ์ 20 ปี ในโรงพยาบาลเจ้าพระยายมราช

Abstract

                     Vascular access is a procedure to perform as a well versed alternative form of renal replacement therapy. In the period of 20 years from 1988 to 2007, the patients of end stage renal disease (ESRD) in Chaoprayayomaraj Hospital were operated to make 178 permanent vascular access; of which 163 radiocephalic fistulas and 15 bracheocephalic fistulas.  The operations were unsuccessful in 19 cases (10.67%).  And 21 cases (11.78%) had postoperative complications such as steal syndrome (38.10%), infection (14.29%), thrombosis (9.52%), aneurysm (9.52%).  All cases delveloping steal syndrome had bracheocephalic fistulas, while radiocephalic fistulas had low and minor postoperative complications.  It was concluded that the operations were highly successful, once the patient was optimally selected; and it could be the good choice for the young surgeons in the country to cope with the increasing ESRD patients.

Key words:      ESRD., permanent vascular access, radiocephalic fistula