Complication Analysis in Primary Vascular Access Surgery in Patients Requiring Hemodialysis

The present study retrospectively analyzes data from 149 primary vascular access operations to evaluate the effect of surgical approach and surgical expertise on the rates of success and of complication for this surgery. All but 10 of the 149 operations involved construction of Cimino-Brescia (C-B) fistulae, the remaining 10 were loop-shunts. All operations were performed consecutively by five different surgeons who were categorized according to skill level as expert (ES), less expert (LES), or trainee (TS) surgeons. The authors recorded the types of complications, duration of patency, types and incidence of repeat surgery, adequacy of vascularization during all surgeries, time of onset of complications, surgical technique, and surgical skill level. Early complications were defined as those occurring within 30 days of surgery and late complications as those manifested thereafter. The presence of low flow in the fistulae on postoperative dialysis prompted angiography, color-Doppler echocardiography, or fis...