Management of perianastomotic stenosis of direct wrist autogenous radial-cephalic arteriovenous accesses for dialysis

Abstract

Our results suggest that the treatment of anastomotic stenoses should be surgical rather than endovascular. Angioplasty and surgery have shown similar results when used to treat other perianastomotic stenoses, but repeat procedures were more frequent with angioplasty.

Endovascular Treatment of Juxta-anastomotic Venous Stenoses of Forearm Radiocephalic Fistulas: Long-term Results and Prognostic Factors

“…As a consequence, the results obtained specifically in JASs of forearm AVFs seldom have been reported, with 1-year PP and APP/SP rates of 41%-60% and 64%-96%, respectively (6,(15)(16)(17). Moreover, little is known about the prognostic factors that could influence the outcome of endovascular procedures in the specific group of JASs of forearm stenoses.…”

A spontaneous pre-anastomotic occlusion does not necessarily impair forearm native dialysis fistulas: echo-Doppler, 3D MR angiographic and digital subtraction angiographic imaging

“…This thrombosis must be treated without any delay because the inflammatory contact between the thrombus and the wall of the vessel will exert a pernicious effect on the permeability of the vein in the long term (1, 3). The clot must be resected surgically or sucked up percutaneously and a new anastomosis must be constructed some centimeters upstream (9).…”

“…In cases where the opposite is true, as we mentioned above, a new anastomosis will have to be constructed some centimeters upstream the former one after a possible thrombosis has been treated (3,9).…”

“…If a steal had occurred, we would have resorted to ligating the distal radial artery and to constructing a new cephalic anastomosis. We will also select this method should a restenosis appear, for it seems more perennial than percutaneous dilation (9).…”

Direct transpectoral approach for level III axillary lymph node clearance

“…1,2 Access and visualisation is important if injury to neurovascular structures in the area is to be avoided. Exposure can be suboptimal in obese patients, those with extensive tumour involvement and those undergoing reoperation for level III recurrence.…”