Side-to-side versus end-to-side anastomosis in distal radiocephalic arteriovenous fistula: A retrospective comparative study of maturation,patency and complications
Restricted accessResearch articleFirst published online May, 2026
Side-to-side versus end-to-side anastomosis in distal radiocephalic arteriovenous fistula: A retrospective comparative study of maturation,patency and complications
This study compared side-to-side (STS) versus end-to-side (ETS) anastomosis in distal radiocephalic arteriovenous fistula (AVF) regarding maturation, patency and complications.
Methods:
This was a single-centre, retrospective analysis of patients who underwent distal radiocephalic AVF creation between April 2018 and June 2024. Primary and secondary patency, maturation, thrombosis and reintervention rates were evaluated.
Results:
No significant perioperative complications occurred among 151 STS and 122 ETS patients. Secondary patency rates were similar (STS 97% vs ETS 93%, p = 0.229). Primary patency was higher in the STS group (56% vs 43%, p = 0.025), though time to patency loss was comparable (p = 0.378). Maturation rates without intervention were 89% (STS) and 83% (ETS), with no statistically significant difference (p = 0.158). Fistula flow was higher with STS. AVF thrombosis was more frequent in ETS (10% vs 3%, p = 0.000), as was radial artery thrombosis (5% vs 0.7%, p = 0.032).
Conclusions:
Our findings suggest STS is a safe, effective alternative to ETS in appropriate clinical settings.
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