[Salvage of vascular access: a case study from the Columbus nephrology division, Rome, Italy]

Introduction: Arteriovenous fistula (AVF) salvage procedures play a crucial role in the care of the uremic patient, influencing quality of life and overall survival. In this study, we report on our centre's experience and analyse the outcomes, in terms of cumulative patency, of surgical salvage procedures on complicated AVFs. Methods: Our study included patients who underwent surgical salvage procedures of their AVFs in our centre from 22/12/2009 to 29/12/2011. Early and late salvage procedures were analysed separately. Results: Of 617 vascular access procedures, 136 salvage procedures were performed, 24 of which were defined as early and 112 as late. Among salvage procedures, re-anastomosis was the most frequently performed, (37.2%), followed by AVF declotting (34.1%) and aneurysm removal (14.0%). Cumulative patency at 3, 6, and 12 months were 91%, 83% and 77% respectively. Conclusions: Our study shows that surgical salvage procedures are a viable option for complicated AVFs, providing optimal short- and long-term results in terms of patency.