No abstract

Although, the autogenous RCAVF is considered to be the primary choice for vascular access, this meta-analysis indicates a high primary failure rate and only moderate patency rates at 1 year of follow-up.

Although there were more interventions needed for access salvage in the patients with prosthetic graft implants, we may conclude that patients with poor forearm vessels do benefit from implantation of a prosthetic graft for vascular access.

We treated 249 patients for ingrowing toenails in a prospective randomised study which compared wedge excision with segmental phenol cauterisation. Follow-up of 97% was at a minimum of 14 months. The analgesic requirement was significantly lower after phenol cauterisation (p less than 0.001), and significantly fewer patients needed to miss school or work (p = 0.001). Recurrence of ingrowth was seen in 16% after wedge excision and 9.6% after phenol cauterisation (not significant), but re-operation was significantly less frequent after phenol (p less than 0.01). Phenol cauterisation gives better short-term and long-term results than wedge resection.

MS-CTA can provide good visualization of forearm HD access AVF and has moderate sensitivity, but high specificity for the detection of flow-limiting stenoses.

The cephalic vein has the fewest PVs and almost a third of them connect to the muscles. This is probably important for the maturation of the AVF, the superficial flow volume and the accessibility for puncture.

These results indicate that a "closed" technique reduces wound complication rate, without negative effects on the short term patency rates. The "closed" technique results in an increased number of postoperative treatments for residual arteriovenous fistulae.

To evaluate our experience of selective iliac artery stenting for total occlusions, a prospective observational study of 25 patients with an occluded iliac artery was designed to run from January 1996-May 1997. Exclusion criteria were an occlusion extended to the femoral artery, claudication Grade III or IV, according to the standards for reports dealing with lower extremity ischemia, and vascular (bypass) surgery in the past. Complete recanalization and selective stent placement was possible in all patients. No complications occurred. In one patient re-stenosis happened inside the stent after a year. Percutaneous reintervention was performed with success. The mean ankle-brachial pressure increased from 0.46 before the procedure to 0.95 after the procedure. After two years of follow-up, the mean ankle-brachial pressure is 0.93. The clinical stage improved by at least one grade to Grade 0 (Rutherford classification). The overall probability of patency for occluded iliac arteries in this study was 95% after two years. Recanalization, followed by percutaneous transluminal angioplasty (PTA) in the treatment of iliac artery occlusions, is our first choice of intervention, considering the absence of complication and satisfactory patency rates in patients with claudication Grade I or II.