Latero-lateral femoro-femoral arteriovenous fistula: a new surgical approach for hemodialysis patients with no vascular access

Cerri, Jesualdo; Ramacciotti, Eduardo; Gomes, Marise; Filho, Wagner Tedeschi; Piccinato, Carlos Eli

doi:10.1590/s0102-86502011000100013

Cited by 5 publications

(6 citation statements)

References 17 publications

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“…Routine preoperative upper extremity mapping with ultrasound not only increases AVF construction rate, but also their maturation likelihood [54] . A new surgical approach for VA for HD using a laterolateral AVF in the thigh between the femoral artery and superficial femoral vein transposed to the subcutaneous layer in patients with no other access options is described by Cerri et al [55] . The new surgical approach for access for HD represents a feasible procedure, with acceptable patency rates in exceptional cases where no other access option is available.…”

Section: Permanent Vamentioning

confidence: 99%

Vascular access today

Pantelias

Grapsa²

2012

WJN

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The number of patients with chronic kidney disease requiring renal replacement therapy has increased worldwide. The most common replacement therapy is hemodialysis (HD). Vascular access (VA) has a key role for successful treatment. Despite the advances that have taken place in the field of the HD procedure, few things have changed with regards to VA in recent years. Arteriovenous fistula (AVF), polytetrafluoroethylene graft and the cuffed double lumen silicone catheter are the most common used for VA. In the long term, a number of complications may present and more than one VA is needed during the HD life. The most common complications for all of VA types are thrombosis, bleeding and infection, the most common cause of morbidity in these patients. It has been estimated that VA dysfunction is responsible for 20% of all hospitalizations. The annual cost of placing and looking after dialysis VA in the United States exceeds 1 billion dollars per year. A good functional access is also vital in order to deliver adequate HD therapy. It seems that the native AVF that Brescia and Cimino described in 1966 still remains the first choice for VA. The native forearm AVFs have the longest survival and require the fewest interventions. For this reason, the forearm AVF is the first choice, followed by the upper-arm AVF, the arteriovenous graft and the cuffed central venous catheter is the final choice. In conclusion, VA remains the most important issue for patients on HD and despite the technical improvements, a number of problems and complications have to be resolved.

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Section: Permanent Vamentioning

confidence: 99%

Vascular access today

Pantelias

Grapsa²

2012

WJN

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“…Finally, tunnel the vein subcutaneously and anastomose it end-to-side to the greater saphenous vein near the sapheno-femoral junction. The mean patency was reported to be 38 months (7) (Fig. 2).…”

Section: Lower Extremitiesmentioning

confidence: 99%

“…1). Alternatively, a latero-lateral arteriovenous fistula could be created close to the adductor canal between the femoral artery and superficial femoral vein (7). First, create a side-to-side anastomosis from the superficial femoral artery to superficial femoral vein above the knee.…”

Section: Lower Extremitiesmentioning

confidence: 99%

See 1 more Smart Citation

Unusual Sites for Hemodialysis Vascular Access Construction and Catheter Placement: A Review

2015

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As more end-stage renal disease patients require hemodialysis and live longer, many will fail to develop or maintain a functioning upper extremity vascular access. When a patient exhausts vascular access sites in the upper extremities, new fistulas and grafts can be constructed in the lower extremities, thorax, and abdomen as long as a pair of proximate artery and vein provide adequate blood inflow and outflow, respectively. When only a moderate size vein with adequate blood flow provides a conduit to either a patent superior or inferior vena cava, inserting a double-lumen venous hemodialysis catheter can provide temporary or permanent access. We review the literature and report the unusual sites for hemodialysis vascular access and catheter placement.

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“… 52 , 53 Unfortunately, given the high-flow nature of femoral artery and vein, up to 20% of these fistulas develop ischemic complications requiring fistula ligation. Femoral-artery–superficial-femoral-vein fistulas 54 and popliteal-artery–femoral-vein fistulas have been described, but outcome data are limited. 55 …”

Section: Last Access Optionsmentioning

confidence: 99%