effect of heparin on the patency of arteriovenous fistula

patients with end stage renal disease need a good vascular access for hemodialysis. arteriovenous fistula is the method of choice for vascular access in these patients. however, failure of arteriovenous fistula due to thrombosis is a major problem. the aim of this study was to evaluate the effect of the heparin on the patency of the arteriovenous fistula. this prospective interventional case control study was performed from november 2003 through may 2005 in vascular surgery ward in imam reza hospital. all the patients who underwent a surgery in order to perform an arteriovenous fistula in cubital or snuff box areas for the dialysis means were enrolled. they were randomly divided into two groups. the case group (n = 96) received intraoperative heparin whereas the controls (n = 102) did not. early observation of arteriovenous fistula (immediately after surgery) showed patency in 89% of heparin group and in 87% of the control group. the patency rate 2 weeks after the surgery was 85% in heparin group versus 74% in the control group, resulting in a statistically significant difference ( p value = 0.046). according to higher patency rate of arteriovenous fistula in 2 weeks following surgery in case group, we recommend intraoperative use of heparin in arteriovenous fistula operations.