The journal of vascular access · 2011
Extending outflow brachial vein length for transposition arteriovenous fistulas.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Jennings William C, Howard C Anthony, Lee Fred S, McMurray Dirk
Аннотация
PURPOSE: Transposition arteriovenous fistulas (T-AVF) play an important role in establishing autogenous vascular access for many hemodialysis patients. When the basilic vein is not available, one of the paired brachial veins offers a reliable T-AVF option, generally as a two-staged operation. Uncommonly, the brachial vein outflow conduit dissipates into multiple small branches communicating with the paired brachial vein or occasionally with a residual proximal segment of the basilic vein. We utilized parallel outflow vein component segments to create additional outflow vein length necessary for successful T-AVFs in these patients.
MATERIALS AND METHODS: We identified four patients where a vein length extension technique utilizing parallel and overlapping vein segments with an end-to-end anastomosis gained adequate length for successful T-AVFs. All transpositions were based on a first stage AVF with access outflow established into a brachial vein.
CASE REPORTS: Three of the operations utilized paired brachial vein segments and one gained needed access outflow length with a brachial vein anastomosis to a residual proximal basilic vein segment. All four patients had functional T-AVFs at 4, 5, 7, and 14 month follow-up. None of the patients developed arm swelling.
CONCLUSIONS: Creating a longer transposition AVF venous outflow segment using parallel and overlapping vein segments with an end-to-end anastomosis gained the adequate length needed for successful T-AVFs in these four patients.
MATERIALS AND METHODS: We identified four patients where a vein length extension technique utilizing parallel and overlapping vein segments with an end-to-end anastomosis gained adequate length for successful T-AVFs. All transpositions were based on a first stage AVF with access outflow established into a brachial vein.
CASE REPORTS: Three of the operations utilized paired brachial vein segments and one gained needed access outflow length with a brachial vein anastomosis to a residual proximal basilic vein segment. All four patients had functional T-AVFs at 4, 5, 7, and 14 month follow-up. None of the patients developed arm swelling.
CONCLUSIONS: Creating a longer transposition AVF venous outflow segment using parallel and overlapping vein segments with an end-to-end anastomosis gained the adequate length needed for successful T-AVFs in these four patients.