Long-term outcomes of transposed femoral vein arteriovenous fistula for abandoned upper extremity dialysis access

Orion, Kristine C.; Kim, Tanner; Cardella, Jonathan; Rizzo, Anthony; Sarac, Timur P.

doi:10.1016/j.jvs.2020.12.065

Cited by 4 publications

(7 citation statements)

References 25 publications

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“…The careful selection of the appropriate body habitus is critical because of the need to superficialize the conduit. Avoidance of the high body mass index (BMI) patient and avoidance of those patients with anatomically short groin to knee length is advised to ensure sufficient vein length (10)(11)(12)(13)(14)(15) for adequate future cannulation (9). Prior to construction of a FV transposition, we confirm and document that the ipsilateral lower extremity circulation is normal (palpable pulses or an ABI of greater than or equal to 0.1 with compressible arteries) to mitigate the risk of vascular access associated steal (VAAS).…”

Section: Fv Transpositionmentioning

confidence: 78%

“…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: 91%

“…Autogenous FV access in ESRD patients has good durability with higher primary and secondary patency rates at 12 months compared to the use of prosthetic ones. Orion et al ( 12 ) showed that FV transposition has good long-term patency rates, where 5-year primary and secondary patency rates were 74% and 89%, respectively. Another study by Bourquelot et al ( 13 ) reported 1- and 9-year primary patency rates of 91% and 45%, respectively, however, the study’s favorable patency rates are subject to a high degree of selection bias as the majority of their patients were young, non-diabetics with low BMI and normal blood vessels which is not typical for HD patients ( Table 1 ).…”

Section: Llva Surgical Techniquesmentioning

confidence: 99%

“…(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.…”

mentioning

confidence: 99%

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Surgical creation of lower extremity fistula and grafts

Alnahhal¹,

Williams²,

Kirksey³

2023

Cardiovasc Diagn Ther

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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.

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Section: Fv Transpositionmentioning

confidence: 78%

Section: Llva Surgical Techniquesmentioning

confidence: 91%

Section: Llva Surgical Techniquesmentioning

confidence: 99%

mentioning

confidence: 99%

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Surgical creation of lower extremity fistula and grafts

Alnahhal¹,

Williams²,

Kirksey³

2023

Cardiovasc Diagn Ther

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“…Common alternatives include the lower extremity access and HeRO grafts. [5][6][7][8] But in situations where they can't be used, as last resort, HD access using intrathoracic veins should be considered. Therefore, we determined that indications for the BATAVG are patients with exhausted lower extremity veins or peripheral arterial obstructive disease unable to use lower extremity arteries or who refuse lower extremity access in patients with bilateral CVO.…”

Section: Discussionmentioning

confidence: 99%

Brachio-azygos transthoracic arteriovenous grafts for hemodialysis patients with bilateral central venous obstruction: A small case series

Song

Park

2021

J Vasc Access

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Background: It is difficult to find a reliable outflow vein for vascular access in hemodialysis patients with bilateral central venous obstruction. The lower extremity veins are currently used as the most common alternative veins to make a new vascular access. However, in patients not amenable to make lower extremity access, intrathoracic vein should be considered as an outflow vein, but there are limitations in its use due to postoperative complications. Methods: We introduce a series of cases that underwent arteriovenous graft operation using an intrathoracic vein, the azygos arch, as an outflow vein. Brachio-azygos transthoracic arteriovenous graft is a surgical procedure that anastomoses the azygos arch and the brachial artery with 7 mm ringed polytetrafluoroethylene graft via lateral thoracotomy without median sternotomy. Results: The chest tubes of the patients were removed on the third postoperative day and they discharged within a week. About 1 month later, hemodialysis was initiated through the BATAVG, and it has been used without access dysfunction. Conclusion: Brachio-azygos transthoracic arteriovenous grafts were performed using the azygos arches without major complications. The azygos arch can be a good alternative outflow vein to make a new vascular access for hemodialysis patients with bilateral central venous obstruction.

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