Femoral vein transposition is a durable hemodialysis access for patients who have exhausted upper extremity options

Farber, Alik; Cheng, Thomas W.; Nimmich, Andrew; Jones, Douglas W.; Kalish, Jeffrey; Eslami, Mohammad H.; Hardouin, Scott; Siracuse, Jeffrey J.

doi:10.1016/j.jvs.2019.07.062

Cited by 12 publications

(7 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A recomendação atual é que a fístula em membro superior seja a primeira escolha para o acesso permanente para hemodiálise 4 . No entanto, diante do desafio da impossibilidade do acesso em membros superiores, técnicas excepcionais podem ser utilizadas, como a transposição do veia braquial, a confecção de FAV no membro inferior autógena ou com prótese, entre outras [5][6][7][8][9][10][11] . A utilização de cateter de longa permanência em veia femoral só é indicada em pacientes com múltiplas comorbidades e baixa expectativa de vida 4 .…”

Section: Discussionunclassified

Transposição de veia femoral superficial como solução de acesso vascular para hemodiálise

et al. 2022

View full text Add to dashboard Cite

Resumo O crescimento significativo do número de indivíduos dependentes de hemodiálise para terapia renal substitutiva e o uso irrestrito de cateteres de curta e longa permanência têm desafiado os cirurgiões vasculares em busca de soluções para a exaustão de acessos nos membros superiores e taxas crescentes de estenose venosa central nesses pacientes. Na impossibilidade do acesso em membros superiores, técnicas excepcionais podem ser utilizadas, e os membros inferiores são uma alternativa factível como sítio de acesso vascular para hemodiálise. Este artigo relata um caso de transposição de veia femoral superficial para confecção de uma fístula arteriovenosa em alça em um paciente sem possibilidade de acessos nos membros superiores, além de fazer uma revisão da literatura sobre essa técnica ainda pouco utilizada.

show abstract

Section: Discussionunclassified

Transposição de veia femoral superficial como solução de acesso vascular para hemodiálise

et al. 2022

View full text Add to dashboard Cite

show abstract

“…4 However, when faced with the challenge of no possible options for upper limb accesses, exceptional techniques can be employed, such as transposition of the brachial vein or creation of an autogenous or prosthetic lower limb AVF, among others. [5][6][7][8][9][10][11] Use of a long-dwell catheter in the femoral vein is only indicated in patients with multiple comorbidities and short life expectancy. 4 Patency rates for SFVt are superior to those achieved with prosthetic loops, 10 particularly because infections are much more common in lower-limb PTFE loops.…”

Section: Discussionmentioning

confidence: 99%

Superficial femoral vein transposition as a solution for hemodialysis vascular access

et al. 2022

View full text Add to dashboard Cite

The significant growth in the number of individuals dependent on hemodialysis for renal replacement therapy and unrestricted use of short and long-term catheters have challenged vascular surgeons in search of solutions for patients whose options for access via the upper limbs have been exhausted and for the increasing rates of central venous stenosis in these patients. When access via the upper limbs is impossible, exceptional techniques can be used and the lower limbs offer feasible alternative vascular access sites for hemodialysis. This article reports a case of superficial femoral vein transposition to make a loop arteriovenous fistula in a patient with no possibility of access via the upper limbs and presents a literature review on this technique that remains little used.

show abstract

“…Wound-related or minor complications such as infection, hematoma, delayed wound healing, lymphocele, and minor edema were reported by Orion et al ( 12 ) (6/21), Farber et al ( 17 ) (4/21), Hazinedaroğlu et al ( 18 ) (5/15), Scollay et al ( 19 ) (11/15), and Bourquelot et al ( 13 ) (10/70). The wide variation in the reported complication rates might be due to the studies’ small sample size and different definitions of wound-related or minor complications.…”

Section: Llva Surgical Techniquesmentioning

confidence: 92%

Surgical creation of lower extremity fistula and grafts

Alnahhal¹,

Williams²,

Kirksey³

2023

Cardiovasc Diagn Ther

View full text Add to dashboard Cite

Lower limb vascular access (LLVA) should be considered for patients in whom upper extremity access has been exhausted. The decisional process around vascular access (VA) site selection should incorporate a patient centered approach that aligns with End Stage Kidney Disease life-plan as recently described in proffered in 2019 Vascular Access Guidelines. The current surgical approaches to LLVA can be divided into two main groups: (A) autologous arteriovenous fistulas (AVFs); (B) synthetic arteriovenous grafts (AVGs). The autologous AVFs include both the femoral vein (FV) and great saphenous vein (GSV) transpositions, while prosthetic AVGs in the thigh position are appropriate for certain patient subtypes. Good durability has been described for autogenous FV transposition as well as AVGs with both demonstrating acceptable primary and secondary patency rates. Major complications such as steal syndrome, limb edema, and bleeding and minor complications such as wound-related infection, hematoma and delayed wound healing have been noted. LLVA is commonly reserved for the patient in whom the only alternative VA may be a tunneled catheter with its attendant morbidity. In this clinical circumstance, successful LLVA has the opportunity to be a life-saving surgical therapy when successfully performed. We describe a thoughtful approach that focuses on patient selection to optimize success and mitigate complications associated with LLVA.

show abstract

Femoral vein transposition is a durable hemodialysis access for patients who have exhausted upper extremity options

Cited by 12 publications

References 33 publications

Transposição de veia femoral superficial como solução de acesso vascular para hemodiálise

Transposição de veia femoral superficial como solução de acesso vascular para hemodiálise

Superficial femoral vein transposition as a solution for hemodialysis vascular access

Surgical creation of lower extremity fistula and grafts

Contact Info

Product

Resources

About