Saphenofemoral arteriovenous fistula as hemodialysis access

SFAVFs were evaluated using the following variables: immediate results, early and late complications, intraoperative and postoperative complications (up to day 30), efficiency of the fistula after the onset of needling and complications associated to its use.Fifty-six SFAVF fistulas were created in 48 patients. Eight patients had two fistulas: 8 patent (16%), 10 transplanted (20%), 12 deaths (24%), 1 low flow (2%) and 20 thrombosis (39%) (first two months of preparation). One patient had severe hypotension during surgery, which caused thrombosis of the fistula, which was successfully thrombectomised, four thrombosed fistulae were successfully thrombectomised and revised on the first postoperative day. After 59 months of follow-up, primary patency was 44%.SFAVF is an adequate alternative for patients without the possibility for other access in the upper limbs, allowing efficient dialysis with good long-term patency with a low complication rate.The establishment of vascular access for hemodialysis (HD) remains a challenge for vascular surgery. Due to the improvement of chronic renal failure treatment and consequently, increased survival, maintenance of vascular access and long-term treatment of its complications, it has become an important cause of hospitalization, morbidity and patient costs [1,2].The access of choice for HD is a primary arteriovenous (AV) fistula in the upper limb, between the radial artery and the cephalic vein [3-6]. This technique increases venous flow approximately 250-300 ml per minute, which is the minimum flow velocity needed to obtain the appropriate clearance of urea after 4 hours of HD. The preference for its use is due to the longer period of working of these AV communications, low rate of complications and easy handling [7-9]. Prolonged use of these accesses may lead to complications such as infection, puncture pseudoaneurysm, anastomotic pseudoaneurysm, venous hypertension, distal ischemia and their own obstruction [10]. In this situati