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Murine Model of Central Venous Stenosis using Aortocaval Fistula with an Outflow Stenosis
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Post-anastomotic venous stenosis after Optiflow deployment: An unexpected outcome
Ziad Al Adas1, George Haddad1, Bhavin C Patel2
1Department of Vascular Surgery, Henry Ford Hospital, Detroit, MI, USA.
SAGE Open Medical Case Reports
|June 19, 2019
Summary
Arteriovenous fistula failure is a common problem for dialysis patients. A new device, Optiflow, aimed to reduce stenosis, but a case report details a new complication: peri-anastomotic venous stenosis.
Area of Science:
- Vascular Surgery
- Nephrology
- Medical Devices
Background:
- Arteriovenous fistula (AVF) failure is a significant cause of morbidity, mortality, and healthcare costs in end-stage renal disease (ESRD) patients undergoing hemodialysis.
- Developing and implementing novel devices to improve AVF patency and reduce complications like stenosis remains a critical area of research.
Observation:
- A 50-year-old male with a history of multiple AVF failures due to hypertensive nephropathy underwent brachiocephalic fistula creation utilizing the Optiflow device.
- The patient's AVF, created with the Optiflow device, functioned for 8 months before developing a complication.
Findings:
- The Optiflow device, designed to enhance AVF maturation and reduce stenosis, was associated with a peri-anastomotic venous stenosis in this patient.
- This represents the first reported instance of this specific complication occurring distal to the Optiflow device.
Implications:
- This case highlights a potential, previously undocumented complication associated with the Optiflow device, necessitating further investigation.
- Understanding and mitigating such complications are crucial for optimizing AVF outcomes and patient care in hemodialysis.
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