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Primary External Stenting of an Autogenous Brachial-Basilic Upper Arm Transposition
Christoph Kuemmerli1, Dominik Habrina1, Stefan Puchner1
1Surgery and Vascular Surgery, Hanusch Hospital, Vienna, Austria.
Annals of Vascular Surgery
|November 29, 2019
Summary
External support during arteriovenous fistula creation can prevent high-output heart failure. This technique successfully limited shunt flow in a patient undergoing hemodialysis access surgery.
Area of Science:
- Vascular Surgery
- Cardiology
- Nephrology
Background:
- High-volume shunt flow from arteriovenous fistulas (AVFs) used for hemodialysis can lead to high-output heart failure.
- Preventing excessive venous dilatation is crucial for managing shunt flow and preventing cardiac complications.
Observation:
- A 62-year-old female patient underwent brachial-basilic upper arm transposition for AVF creation.
- The Frame™ external support (stent) was utilized during AVF creation to limit vein dilatation.
- Post-maturation, the AVF was used for dialysis, with shunt flow plateauing at 3 months.
Findings:
- The use of external support during AVF creation effectively limited vein dilatation and subsequent high-volume shunt flow.
- The intervention demonstrated safety and feasibility in managing potential complications associated with AVF creation.
Implications:
- This approach offers a potential strategy to mitigate the risk of high-output heart failure in patients requiring hemodialysis access.
- Further investigation into external support devices for AVF construction may improve patient outcomes and reduce cardiovascular morbidity.
