Effects of Perforating Vein Ligation on Symptoms of Venous Hypertension in Side to Side Arteriovenous Fistula Procedure

Background: The widespread availability of dialysis prolongs the lives of patients with end-stage renal disease (ESRD). However, repairing failing vascular access lead to longer hospitalization and increased costs throughout the world. Perforating vein ligation causes maximum flow in superficial veins and promotes the maturation of arteriovenous fistula (AVF). We thus postulated that it can reduce the risk of steal syndrome and venous hypertension. Methods: This clinical trial study was performed on 70 patients for whom side to side cubital AVF was fixed. The subjects were divided to two groups of 35. In one group, the perforating vein was ligated while in the other, it was not. The two groups were then compared regarding age, sex, and signs and symptoms of venous hypertension. Findings: The mean age of our participants was 58.6 ± 16.2 years (range: 13-84 years). There were not any statistically significant differences in sex or signs and symptoms of venous hypertension between the two groups. In addition, except smoking, the two groups did not have significant differences in ESRD risk factors (renal disease, hypertension, diabetes mellitus, hepatic disease, ischemic heart disease, smoking, and addiction). Conclusion: Our study showed that perforating vein ligation did not have any effects on improving the signs and symptoms of venous hypertension in patients with side to side cubital AVF. Keywords: Perforating vein, Venous hypertension, Side to side arteriovenous fistula, Lipodermatosclerosis, Steal syndrome