Abstract: 【Abstract】Objective To discuss the effect of different cannulation methods on the complications of autologous arteriovenous fistula and dialysis adequacy. Methods A total of 91 maintenance hemodialysis (MHD) patients with autologous arteriovenous fistula were enrolled in this study. They were divided into
group A (n=52, puncturable fistula vessel length ≥5 cm), and group B (n=39, puncturable fistula vessel length ＜5 cm). Patients in group A were subdivided into group A1 (n=26, blunt needle buttonhole cannulation) and group A2 (n=26, rope-ladder cannulation); patients in group B were subdivided into group B1 (n=20, blunt needle buttonhole cannulation) and group B2 (n=19, regional area cannulation). After 12 months, dialysis adequacy, internal fistula vascular stenosis, aneurysm, blood flow, bleeding, hematoma, infection, vascular occlusion were compared between groups A1, A2, B1 and B2. Results There was no statistical difference in dialysis adequacy between group A and group B (P＞0.05). The incidence of vascular stenosis (P=0.009) and blood flow insufficiency (P=0.039) were higher in group A2 than in group A1; the incidence of bleeding extravasation (P=0.007) and aneurysm (P=0.047) were higher in group B2 than in group B1. Conclusion Blunt needle buttonhole cannulation can reduce the incidence of complications including vascular stenosis, aneurysm, blood flow insufficiency and bleeding and ensure dialysis adequacy. So it is a safe and effective cannulation method for AVF with different length of puncturable fistula vessel.

Key words:  Autologous arteriovenous fistula, Cannulation method, Buttonhole cannulation