Native Upper Limb Arteriovenous Fistula for Hemodialysis: Single-Center Experience in Iraq.

Taha, Abdulsalam Y; Khuzaim, Murtadha Awad

doi:10.33762/basjsurg.2026.166304.1148

	Native Upper Limb Arteriovenous Fistula for Hemodialysis: Single-Center Experience in Iraq.
Basrah Journal of Surgery
Article 3, Volume 32, Issue 1, 2026, Pages 23-32 PDF (901.74 K)
Document Type: Research Paper
DOI: 10.33762/basjsurg.2026.166304.1148
Authors
Abdulsalam Y Taha^* ¹; Murtadha Awad Khuzaim²
¹Department of Cardiothoracic and Vascular Surgery, Branch of Clinical Sciences, College of Medicine, University of Sulaimani, Sulaimani, Region of Kurdistan, Iraq
²Department of Thoracic and Cardiovascular Surgery, Al-Kadhimiyah Teaching Hospital, Baghdad, Iraq.
Abstract
Objective Native arteriovenous fistulas (AVFs) remain the preferred vascular access for hemodialysis due to superior patency and lower complication rates. This study evaluates the success, complication rates, and clinical outcomes of AVF creation in end-stage renal disease (ESRD) patients at a tertiary hospital in Baghdad, Iraq. Methodology A prospective study was conducted from April 2023 to April 2024, involving 75 ESRD patients (42 males, 33 females), aged 12 to 98 years, who underwent upper limb AVF creation. Comprehensive demographic, clinical, and procedural data were collected through patient interviews, physical exams, and systematic documentation in a customized Microsoft Access database. The primary procedure was performed under local anesthesia, and patients were followed for up to six months. Results Successful AVF creation was achieved in 89.3% of cases, with primary failure occurring in 10.7%. Complications were rare, with distal edema (8%), thrombosis (8%), oozing (4%), arterial steal syndrome (2.7%), and an AVF aneurysm (1.3%) reported. Secondary interventions, including thrombectomy (5.3%) and false aneurysm exploration (2.7%), were required in a small number of patients. No fatalities were observed. The average hospital stay was 6.4 hours, with most patients discharged within 4 hours of surgery. Conclusions Upper limb native AVF creation is a safe and effective procedure for ESRD patients, with a high success rate and low complication and mortality rates. Brachio-cephalic AVF (BCAVF) patients exhibited higher complication rates compared to radio-cephalic AVF (RCAVF). Early discharge and short hospital stays were typical, highlighting the procedure's minimal postoperative burden.
Keywords
End-stage renal disease; Arteriovenous fistula; upper limb; Radiocephalic; Brachiocephalic

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