Randomized clinical trial of continuous sutures or non-penetrating clips for radiocephalic arteriovenous fistula

C. J. Zeebregts*, J. J.A.M. Van Den Dungen, R. J. Van Det, E. L.G. Verhoeven, R. H. Geelkerken, R. Van Schilfgaarde

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

19 Citations (Scopus)


Background: Despite several modifications to the original design, patency rates of radiocephalic arteriovenous fistulas have changed little since the first report in 1966. The use of non-penetrating clips for vascular anastomosis on the outcome of such fistulas was studied. Methods: Between January 2000 and August 2003, 107 primary radiocephalic fistulas were constructed in 98 patients. The vascular anastomoses were performed at random with either sutures (n = 56) or clips (n = 51). Results: Although there were trends for better primary and primary assisted patency of clipped fistulas, the differences were not statistically significant. The 6-month primary patency rate was 61 per cent with sutures and 69 per cent with clips (P = 0-393). The mean(s.d.) primary patency was 315(306) and 285(285) days for clipped and sutured fistulas respectively. With regard to secondary patency, clipped fistulas were better (P = 0-009). The mean(s.d.) secondary patency was 435(376) and 344(316) days for clipped and sutured fistulas, respectively. There were no significant differences in flow characteristics, number of revisions or other morbidity. Conclusion: This randomized clinical trial provided further evidence that the use of vascular clips may improve the patency rate of radiocephalic arteriovenous fistulas for haemodialysis.

Original languageEnglish
Pages (from-to)1438-1442
Number of pages5
JournalBritish journal of surgery
Issue number11
Publication statusPublished - 1 Nov 2004
Externally publishedYes


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