Prospective Evaluation of Radiocephalic Arteriovenous Fistula Outcomes in a High-Volume Centre: Patency, Complications, and Influencing Factors

Introduction Despite strong recommendations by the National Kidney Foundation (NKF) for the creation of radiocephalic arteriovenous fistula (RC AVF), most volume centres are reluctant due to contradictory complication rates and sustained patency. Factors influencing outcomes warrant attention, emphasising the importance of tailored approaches. Multicentre studies are recommended for broader validation of these findings. Therefore, the current study aimed to evaluate the outcome of RC AVF in our setup and to identify factors that influence its outcome. Method The prospective observational study was conducted at the Department of Vascular Surgery, Combined Military Hospital Lahore, over a year (October 2022-September 2023), and included 315 patients with RC AVF. Data were collected for demographic variables, comorbidities and fistula patency. The patients were further categorised into three subgroups on the basis of the location of RC AVF: snuff box, distal at the wrist, and proximal in the forearm. Follow-up evaluations were performed at one, six, and 12 weeks postoperatively. Statistical analysis was conducted using SPSS (IBM SPSS Statistics for Windows, IBM Corp., Version 22, Armonk, NY). The result shows that there was male predominance (75.2%). Results The mean age was 51.71 ± 14.94 years. Diabetes mellitus (40.6%) and hypertension (36.8%) were the most prevalent comorbidities. Distal radiocephalic arteriovenous fistula (DRC AVF) at the wrist was the most common access type (47.3%). Complications occurred in 9.2% of patients. Primary patency rates were 98.7% at one week, 92.1% at six weeks, and 90.5% at 12 weeks. Conclusion Radiocephalic fistula demonstrates favourable outcomes in our high-volume centre, with low complication rates and sustained patency. Factors influencing outcomes warrant attention, emphasising the importance of tailored approaches. Multicentre studies are recommended for broader validation of these findings.