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Related Experiment Videos

Transposition, elevation, lipectomy and V-Wing for easy needling.

Pierre Bourquelot1, Lamisse Karam, Helia Robert-Ebadi

  • 11 Department of Angioaccess Surgery, Clinique Jouvenet, Paris - France.

The Journal of Vascular Access
|March 10, 2015
PubMed
Summary

Surgical techniques like tunnel-transposition and lipectomy improve access to deep veins for hemodialysis. These methods facilitate cannulation of basilic and cephalic veins in various patient populations.

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Area of Science:

  • Vascular Surgery
  • Nephrology
  • Dialysis Access

Background:

  • Deeply situated veins pose challenges for cannulation during hemodialysis.
  • Arteriovenous Fistula (AVF) creation requires accessible, mature veins for effective dialysis.
  • Obesity and previous scarring can further complicate AVF access.

Purpose of the Study:

  • To describe surgical techniques for superficializing deep veins to facilitate cannulation.
  • To evaluate the efficacy and outcomes of these techniques for AVF creation.

Main Methods:

  • Basilic vein tunnel superficialization and rerouting for brachial-basilic AVF.
  • Femoral vein superficialization as a one-stage procedure.
  • Lipectomy for superficialization of forearm radial-cephalic AVF in obese patients.

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Main Results:

  • Brachial-basilic AVF superficialization achieved high long-term patency rates (1-year primary: 91%, secondary: 84%; 9-year primary: 45%, secondary: 56%).
  • Forearm radial-cephalic AVF superficialization via lipectomy showed good patency (3-year primary: 63%, secondary: 88%).
  • Femoral vein superficialization is effective but has contraindications and potential complications.

Conclusions:

  • Tunnel-transposition and lipectomy are effective for accessing deep basilic and cephalic veins.
  • These techniques improve cannulation ease for hemodialysis access.
  • Careful patient selection is crucial for femoral vein superficialization.