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[Transposition of the basilic vein in the arm for vascular access in hemodialysis]
1Oddĕlení kardiovaskulární a transplantacní chirurgie 1. LF UK, VFN, Praha.
Insights
This study explores a less common vascular access method for patients needing repeated arteriovenous (AV) shunts. The approach demonstrated promising patency rates and minimal complications, offering a viable alternative to standard procedures.
Area of Science:
- Vascular Surgery
- Nephrology
- Interventional Radiology
Context:
- Patients requiring repeated vascular access for hemodialysis often face challenges with traditional arteriovenous (AV) shunts.
- Evaluating alternative surgical techniques is crucial for improving long-term access patency and patient outcomes.
Purpose:
- To assess the efficacy and safety of a less frequently used vascular approach for creating arteriovenous shunts.
- To determine the patency rates and complication profile of this specific surgical technique in a cohort of patients.
Summary:
- A retrospective analysis of 10 patients who underwent this alternative AV shunt procedure between 1994-1995.
- Achieved 80% patency at one year, with 7 shunts remaining functional after two years.
- Complications occurred in three patients, but none necessitated shunt removal; two shunts closed within 11 months.
Impact:
- This vascular approach presents a potentially valuable alternative to secondary vascular access methods, including the use of vascular prostheses.
- Suggests improved outcomes compared to conventional vascular prostheses for repeat AV shunt creation.
Abstract:
The author presents an account on a less frequently used vascular approach suitable in particular in patients with repeated a-v shunts. The group comprises 10 patients operated in 1994-1995. The patency up to one year was 80%, after two years 7 shunts are patent, one female patient died one year after establishment of the shunt with the shunt in a functional state. One shunt closed after six months and the second one 11 months after operation. Complications were recorded in three patients, in none of them abolition of the shunt was necessary. Based on the author's experience and data in the literature the authors assume that this approach is a useful alternative to secondary vascular approaches with better results than those of vascular prostheses.