Comparison of proximal radial artery to brachial artery in creation of Arteriovenous Fistula for hemodialysis

Radiocephalic arteriovenous fistula (AVF) at wrist is the vascular choice for dialysis. In the absence of a suitable vein in the wrist, elbow brachiocephalic fistula is the next choice. In this study to create an arteriovenous fistula in antecubital area, we turned to the proximal radial artery in comparison to brachial artery in antecobital area for dialysis. We reviewed 124patients in clinical trial study that candidated for placement of AVF for dialysis in antecubital area. To create AVF, proximal radial artery in 62 patients and brachial artery in 62 other patients selected as the artery of choice,then patients followed based on complications, steal syndrome, primary failure and mean time to prepare for dialysis. The mean time of maturation of AVF in brachial group was 41 days and in radial group was 43 days. Primary dysfunction in brachial group was 6 cases (10%) and in radial group was 5 cases (8%).Steal syndrome in radial group was not seen but in brachial group 2 cases (3%) were seen. According to the primary success, steal syndrome and mean time of maturation of these two arteries had no significant statistic differences, but like other previous studies, this study emphasizes on usefulness and less complications. On the other hand, due to the anterior anatomical position and allowing the release of the artery, it causes easy technique for creating AVF anastomosis to the antecubital arteries and its branches.. Therefore, this study recommends use of this artery in creation of AVF in antecubital area.