Abstract: 【Abstract】Objective The purpose of this paper is to assess the establishment methods and clinical application of perforating vein fistula in elderly hemodialysis patients. Methods A retrospective comparison of elderly patients(75.7±8.9years) undergoing primary vascular access surgery using high arteriovenous fistula (n=54) and perforating vein fistula (n=48) was performed over a 3year period. The general data of patients , procedure success rate, fistula maturation time, blood flow during dialysis, postoperative patency rate and complications of patients with different surgical methods were analyzed. Results The two surgical methods have a one-time success rate of 100%. For elderly diabetic dialysis patients, internal fistula failure can occur in the early stage, patency rates were significantly lower in patients withforearm AVF compared to perforating vein AVF (c2= 6.971, P= 0.008). Comparing the non- diabetic patients oftwo group, there were no significant differences in survival rate (c2= 0.668, P= 0.414). The incidence of pseudoaneurysm and heart failurein observation group was significantly lower than in control group (c2= 5.768, 7.761; P= 0.014, 0.007). There were no significant differences between two groups in thrombosisandswollen hand syndrome (c2=0.956, 0.260; P=0.248, 0.698). Conclusion For the elderly patients with poor vascular condition in wrist and forearm, perforating vein fistula operation may have clinically satisfactory efficacies.

Key words: Vascular access, Perforating veins fistula, Elderly patients, Hemodialysis