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Saphenous vein-popliteal artery fistula for chornic hemodialysis
Insights
A saphenous vein arteriovenous fistula in the thigh provides reliable vascular access for chronic hemodialysis. This method is effective when upper extremity sites are unavailable, with low complication rates.
Area of Science:
- Vascular Surgery
- Nephrology
- Dialysis Access
Background:
- Chronic kidney disease necessitates long-term hemodialysis.
- Vascular access is crucial for effective hemodialysis treatment.
- Upper extremity access sites are often unavailable in some patients.
Purpose of the Study:
- To evaluate the efficacy and safety of saphenous vein arteriovenous fistulas in the thigh for hemodialysis access.
- To assess the saphenous vein-popliteal artery fistula as an alternative for patients lacking upper extremity access.
Main Methods:
- Creation of a saphenous vein arteriovenous fistula in the thigh.
- Subcutaneous tunneling of the saphenous vein.
- Anastomosis of the distal vein to the popliteal artery.
- Preservation of the proximal vein's connection to the femoral vein.
Main Results:
- Seven fistulas were created, with only one experiencing spontaneous thrombosis.
- No cases of infection were reported.
- No instances of vascular insufficiency or high output cardiac failure were observed.
Conclusions:
- The saphenous vein-popliteal artery fistula is a viable and safe option for chronic hemodialysis vascular access.
- This surgical technique provides a satisfactory solution for patients with limited upper extremity access options.
Abstract:
A saphenous vein arteriovenous fistula for chronic hemodialysis can be formed in the thigh by tunneling the vein subcutaneously, anastomosing the distal end to the popliteal artery, and leaving the proximal end attached to the femoral vein. Of seven fistulas, only one has thrombosed spontaneously. There were no instances of infection, vascular insufficiency, or high output cardiac failure. A saphenous vein-popliteal artery fistula can be a satisfactory method of maintaining vascular access in those patients who require chronic hemodialysis but who have no available sites in the upper extremities for construction of a fistula.