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2023-07-18T20:03:56Z2023-07-18T20:03:56Z2021-08-04743659636598https://doi.org/10.34117/bjdv7n4-2262525-8761http://hdl.handle.net/1843/56615https://orcid.org/0000-0001-8134-5825Introdução: A insuficiência renal possui alta prevalência mundial e a principal forma de tratamento é a hemodiálise[1]. As evidências atualmente preconizam a fístula arteriovenosa (FAV) como primeira escolha de acesso para hemodiálise.[2] As fístulas têm maior perviedade e taxas menores de complicações, em comparação às próteses e aos cateteres[3]. No entanto, complicações podem ocorrer sendo a estenose a principal delas, elevando a morbimortalidade. A possível associação entre a modalidade cirúrgica e a ocorrência de estenose pode fornecer um importante parâmetro prognóstico. Objetivos: Avaliar a incidência de estenoses hemodinamicamente significativas em diversas modalidades de cirurgia para confecção de FAV. Metodologia: Estudo observacional prospectivo em pacientes submetidos a confecção de fístula arteriovenosa para hemodiálise, no Hospital das Clínicas da UFMG. Os pacientes foram avaliados, com a utilização de ultrassom vascular com Doppler, em intervalos pré definidos: pós operatório imediato, 1º DPO (dia pós operatório), 7º DPO, 30º DPO e, posteriormente, de 30 em 30 dias até o 210º dia. Resultados:Trinta e um pacientes foram selecionados e submetidos a bloqueio de plexo braquial para criação de FAV. Entre as FAVs realizadas, em 22.5% utilizou-se a técnica braquiobasílica, com superficialização da veia basílica. Nos demais utilizou-se técnicas diversas, como braquiocefálica, radiocefálica, entre outras. Entre as braquiobasílicas, a taxa cumulativa de estenose foi de 71.4%. Entre as outras modalidade utilizadas, a taxa foi de 25% com valor de p de 0,0239. Esse achado é condizente com o encontrado na literatura. Ergene et al. (2020), apresentou em seu estudo que 63,6% das estenoses encontradas ocorreram na técnica de superficialização da veia basílica.[4] Conclusão: As fístulas arteriovenosas braquiobasílicas com superficialização da veia basílica apresentam maior incidência de estenoses hemodinamicamente significativas quando comparadas a outras modalidades cirúrgicasIntroduction: Renal failure has a high prevalence worldwide and the main form of treatment is hemodialysis[1]. The evidence currently recommends the arteriovenous fistula (AVF) as the first choice of access for hemodialysis[2] Fistulas have higher patency and lower complication rates compared to prostheses and catheters[3]. However, complications can occur, stenosis being the main one, increasing morbidity and mortality. The possible association between the surgical modality and the occurrence of stenosis may provide an important prognostic parameter. Objectives: To evaluate the incidence of hemodynamically significant stenosis in several types of surgery for making a VAF. Methodology: This was a prospective observational study of patients who underwent hemodialysis arteriovenous fistula procedures at the Hospital das Clínicas, UFMG. The patients were evaluated using vascular Doppler ultrasound at pre-defined intervals: immediate post-op, 1st PO day (post-op day), 7th PO day, 30th PO day and then every 30 days until the 210th day. Results: Thirty-one patients were selected and submitted to brachial plexus block for AVF creation. Among the AVFs performed, 22.5% used the brachiobasilic technique, with superficialization of the basilic vein. In the others, several techniques were used, such as brachiocephalic, radiocephalic, among others. Among the brachiobasilic techniques, the cumulative stenosis rate was 71.4%. Among the other modality used, the rate was 25% with a p-value of 0.0239. This finding is consistent with that found in the literature. Ergene et al. (2020), presented in their study that 63.6% of the stenoses found occurred in the basilic vein superficialization technique.[4] Conclusion: Brachiobasilic arteriovenous fistulas with basilic vein superficialization have a higher incidence of hemodynamically significant stenoses when compared to other surgical modalities.porUniversidade Federal de Minas GeraisUFMGBrasilMED - DEPARTAMENTO DE CIRURGIABrazilian Journal of DevelopmentProcedimentos Cirúrgicos VascularesInsuficiência RenalFístula arteriovenosaFístula arteriovenosaInsuficiência RenalProcedimentos Cirúrgicos VascularesIncidência de estenoses hemodinamicamente significativas em diversos tipos de acessos para hemodiálise- estudo prospectivoIncidence of hemodynamically significant stenoses in several types of hemodialysis accesses- a prospective studyinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://ojs.brazilianjournals.com.br/ojs/index.php/BRJD/article/view/27927Rafael OliveiraRafaela OliveiraRenata Gomes SeveroGuilherme Castro SantosTulio Pinho Navarroapplication/pdfinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFMGinstname:Universidade Federal de Minas Gerais (UFMG)instacron:UFMGORIGINALIncidência de estenoses hemodinamicamente significativas em diversos tipos de acessos para hemodiálise- estudo prospectivo.pdfIncidência de estenoses hemodinamicamente significativas em diversos tipos de acessos para hemodiálise- estudo prospectivo.pdfapplication/pdf133993https://repositorio.ufmg.br/bitstream/1843/56615/2/Incid%c3%aancia%20de%20estenoses%20hemodinamicamente%20significativas%20em%20diversos%20tipos%20de%20acessos%20para%20hemodi%c3%a1lise-%20estudo%20prospectivo.pdf8a4af881b6dab0a03e47a82540d72706MD52LICENSELicense.txtLicense.txttext/plain; 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