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Faculty of Medical Sciences

Een retrospectieve en gerandomiseerde prospectieve vergelijking van autologe arterioveneuze fistel complicaties tussen de buttonhole- en de rope-ladder/area aanpriktechniek bij hemodialysepatiënten.

Berends, M.A. (2012) Een retrospectieve en gerandomiseerde prospectieve vergelijking van autologe arterioveneuze fistel complicaties tussen de buttonhole- en de rope-ladder/area aanpriktechniek bij hemodialysepatiënten. thesis, Medicine.

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Abstract

Background: For the optimal treatment of hemodialysis patients, it is essential to obtain and maintain an adequate vascular access. Complications, caused by cannulation, have a great impact on the quality and lifespan of native arteriovenous fistulae and lead to an increase in interventions, hospitalizations, morbidity and even mortality. There is a need for a better cannulation technique. The buttonhole technique could be considered. The purpose of this combined retrospective and randomized prospective study is to compare the buttonhole cannulation technique with the traditional cannulation techniques based on the development of native arteriovenous fistula (AV fistula) complications. Material and methods: Retrospective, 56 hemodialysis patients with a native arteriovenous fistula coming from the HD unit of our hospital were compared based on cannulation technique; 28 patients used the buttonhole technique and 28 patients used the traditional technique. Minimal time span of follow-up was six months. In the randomized prospective study 5 patients, using the buttonhole technique, were compared with 8 patients, using the traditional techniques (rope-ladder/area). The following variables were documented for both studies; number of developed aneurysms, stenosis, infections, hematomas, re-bleedings and the need for interventions. Results: Patients in the buttonhole groups developed less hematomas (P<0,001) and re-bleedings (P=0,014) compared to the patients in the rope-ladder/area groups. Both studies showed no evident differences for both groups in numbers of developed aneurysms, stenosis, infections and sustained interventions. Conclusions: The buttonhole technique is associated with less native AV fistula complications, like hematomas and re –bleedings. No significant differences in numbers of developed aneurysms, stenosis, infections and sustained interventions could be observed in both studies. The buttonhole technique seems to have a lot of benefits in comparison to the traditional techniques. But by choosing a cannulation technique, a good evaluation of the patient concerned stays essential.

Item Type: Thesis (Thesis)
Supervisor name: Facultair begeleider: and Kleij, Dr. F.G.H. v/d and Dialyse centrum Emmen and Scheper Ziekenhuis, Emmen
Faculty: Medical Sciences
Date Deposited: 25 Jun 2020 10:40
Last Modified: 25 Jun 2020 10:40
URI: https://umcg.studenttheses.ub.rug.nl/id/eprint/176

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