Axillary Artery to Right Atrium Shunt for Hemodialysis Access in a Patient with Advanced Central Vein Thrombosis: A Case Report

Kopriva, David; Moustapha, Ahmad

doi:10.1007/s10016-006-9032-0

Cited by 16 publications

(12 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Kopriva proposed a shorter and straight shunt preventing from kinking in the mediastinum and reported a 12-month patency with anticoagulation therapy. 9 , 17 Other authors have proposed the creation of a brachial artery-atrial AVG providing hemodialysis access sites for cannulation in the upper arm. 12,18…”

Section: Discussionmentioning

confidence: 99%

Comparison of axillary-atrial and axillary-iliac arteriovenous grafts for hemodialysis access creation

et al. 2019

View full text Add to dashboard Cite

Objective: The aim of this study was to compare two complex vascular access techniques that utilize the axillary artery as inflow and accesses were created with early cannulation grafts: the axillary-atrial arteriovenous graft versus axillary-iliac arteriovenous graft. Methods: This is a retrospective study of end-stage renal disease patients with occluded intrathoracic central veins that underwent complex hemodialysis access creation in our institution after failed endovascular recanalization attempts. Patients’ demographics, comorbidities, number and types of previous accesses, intraoperative variables, and clinical outcomes were collected and compared. Results: Four patients underwent axillary-atrial arteriovenous graft creation with Flixene™ (Atrium™, Hudson, NH, USA) grafts, through a midline sternotomy to expose the right atrium; all were successfully implanted and used for hemodialysis within the first 72 h; one patient developed a pseudoaneurysm in the mid-graft portion, requiring surgical repair, and it is currently functional. Eight axillary-iliac arteriovenous grafts were created; all grafts were patent and were utilized within 96 h after placement. At 6 months of follow-up period, five (62 %) of our patients underwent graft thrombectomy, one (12 %) balloon angioplasty at the vein anastomosis secondary to stenosis, and two (25 %) grafts were removed due to infectious complications. Axillary-atrial arteriovenous graft and axillary-iliac arteriovenous graft primary patency rates at 6 months were 75% and 48%, respectively; 6-month secondary patency of the axillary-atrial arteriovenous graft compares favorably against that of axillary-iliac arteriovenous graft (100% vs 75%, respectively). Conclusion: Despite the invasiveness, direct atrial outflow procedures remain a valid alternative in carefully selected patients with adequate cardiopulmonary reserve.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of axillary-atrial and axillary-iliac arteriovenous grafts for hemodialysis access creation

et al. 2019

View full text Add to dashboard Cite

show abstract

“…If there is no suitable superficial vein, prosthetic AV fistula or brachiobasilic AV fistula with basilic vein transposition are required (23,24). However, if the upper limb use is not appropriate, axillary-axillary AV access (necklace graft) (25), superficial femoral vein transposition (26), axillary artery to right atrial graft (27), hemodialysis reliable outflow graft (28), and femoral AV graft could be used as alternative choices for vascular access (19)(20)(21). Autogenous AV fistula or graft AV fistula are available for femoral AV access, although the former is not preferred because of wide incision and associated complications (19,29,30).…”

Section: Discussionmentioning

confidence: 99%

Percutaneous transluminal angioplasty for dysfunctional femoral hemodialysis graft

Kim²,

Goo³

et al. 2015

Diagn Interv Radiol

View full text Add to dashboard Cite

ORIGINAL ARTICLE PURPOSE We aimed to evaluate the safety and effectiveness of percutaneous transluminal angioplasty (PTA) for dysfunctional femoral arteriovenous graft and analyze clinical or anatomic predictors of graft patency. METHODSThe records of 45 patients who underwent PTA or thromboaspiration for dysfunctional or thrombosed femoral arteriovenous graft from 2005 to 2012 were reviewed retrospectively. Primary and secondary patency rates were determined at three, six, and 12 months after PTA. The primary patency rate was analyzed according to the presence of diabetes mellitus, graft age from the time of creation to the first intervention (<12 months or ≥12 months), presence of thrombus, shape of graft (U-shape vs. straight-shape), anastomosis type of graft (femoral-femoral vs. femoral-saphenous), location of stenosis (central vs. peripheral), length of stenosis (<2 cm vs. ≥2 cm), degree of stenosis severity (<70% vs. ≥70%), and stent insertion. RESULTSA total of 124 PTAs were performed in 45 patients. The primary patency rate at three, six, and 12 months was 84.8%, 63.6%, and 24.2%, respectively. The secondary patency rate at three, six, and 12 months was 95.2%, 95.2%, and 85.7%, respectively. The mean duration of primary and secondary patency was 13.2 and 35.7 months, respectively. No significant clinical or anatomical predictors of primary patency could be identified. Stent placement had a negative effect on primary patency. CONCLUSION PTA is a safe and effective treatment for dysfunctional femoral arteriovenous grafts. Stent placement seems to improve technical success, but does not enhance the primary patency rate of dysfunctional femoral arteriovenous grafts.

show abstract

“…The available evidence for RA grafts is limited to individual case reports and two small series, one of two patients and one of nine patients from 1991 to 2017 (see Table 2). [34][35][36][37][38][39][40][41][42][43][44][45] Age was 19-70 years with a mean age of 46 years. 42,44,46 Graft conduits were autologous vein in four cases, bovine carotid artery in one and PTFE in other reports.…”

Section: Ra Graftsmentioning

confidence: 99%

“…36,37 Thrombosis occurred in 8 cases. 35,40,42,43 One patient suffered from high-output congestive cardiac failure 45 and other with a pericardial effusion. 42 Infection was low with graft infection occurring in 2 patients in a series of 11.…”

Section: Ra Graftsmentioning

confidence: 99%

Options for end stage vascular access: Translumbar catheter, arterial-arterial access or right atrial graft?

et al. 2019

View full text Add to dashboard Cite

Background: Running out of vascular access for dialysis is thankfully rare, but despite this, most units will have a number of patients with few options and in a precarious state. The increasing longevity of dialysis patients portends more patients will reach minimal access options. End stage vascular access is poorly defined but classification may enable assessment and comparison of treatment options. Three options for patients with end stage access are a central venous catheter through a translumbar or transhepatic route, arterial-arterial prosthetic loop or a right atrial graft. Aims: The aims of this study are to provide a structured review of evidence for these procedures to allow application and guide practice for patients with end stage vascular access. Methods: A standardised search of published literature was performed of relevant studies. In addition, the references cited in those papers were assessed for any further available articles. All study types were included and reviewed by two authors independently. Primary outcomes were patient survival and secondary patency rate at 3 and 12 months. Secondary outcomes were long-term patency rates, mean time to cannulation and complications such as access dysfunction, thrombosis and infection. Summary: Based on the available evidence, it would appear that arterial-arterial prosthetic loop is a definitive option for maintaining dialysis access in patients with no more arteriovenous access options. Translumbar and transhepatic dialysis catheters may offer short- and medium-term options and right atrial grafts may also be suitable as an option where arterial-arterial prosthetic loop is unsuitable.

show abstract

Axillary Artery to Right Atrium Shunt for Hemodialysis Access in a Patient with Advanced Central Vein Thrombosis: A Case Report

Cited by 16 publications

References 3 publications

Comparison of axillary-atrial and axillary-iliac arteriovenous grafts for hemodialysis access creation

Comparison of axillary-atrial and axillary-iliac arteriovenous grafts for hemodialysis access creation

Percutaneous transluminal angioplasty for dysfunctional femoral hemodialysis graft

Options for end stage vascular access: Translumbar catheter, arterial-arterial access or right atrial graft?

Contact Info

Product

Resources

About