Saphenous vein loop fistula in the thigh for maintenance hemodialysis

Kinnaert, Paul; Vereerstraeten, Pierre; Toussaint, C; Geertruyden, Jean Van

doi:10.1007/bf01556391

Cited by 13 publications

(10 citation statements)

References 5 publications

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“…While we assume that steal will sometimes be a problem, just as it is in the arm, we do not know of evidence that the presence of the fistula will accelerate atherosclerosis. No such problems were reported in the one series of significant size, although followup was short [2]. These patients have exhausted all other reasonable options, and the lifespan of the fistula (and often the patient, if all options are not used), may well be insufficient to allow atherosclerosis to be a significant problem.…”

Section: Discussionmentioning

confidence: 93%

“…It has been used both as an autologous conduit at a remote site, usually the upper extremity [1,4,7], and as a straight saphenopopliteal graft [8]. It has also been used in a transposed fashion in the thigh, leaving the SF} intact, as we describe here [1][2][3][4][5]. The transposed saphenous vein thigh fistula offers at least two significant advantages.…”

Section: Discussionmentioning

confidence: 99%

“…The risk of infection is, we feel, overstated: the part of the fistula used for cannulation, if enough length IS assured at its creation, is within the thigh not~e groin. In addition, the all-autologous naturõ f this fistula would be expected to reduce the risk of i~fection sUbstanti~lly.when compared with prosthetic, The reported incidence of late infection in a thigh vein~stula seems acceptably low -in reports encompassing 47 such fistulae, only two late infections have occurred [1][2][3][4][5]. .…”

Section: Discussionmentioning

confidence: 99%

“…The greater saphenous vein can be used locally as a thigh saphenofemoral loop [1][2][3][4][5]. This is a rarely performed procedure, however, in part.…”

Section: Introductionmentioning

confidence: 99%

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Transposed Saphenous Vein Arteriovenous Fistula Revisited: New Technology for an Old Idea

Illig

Orloff

Lyden

et al. 2002

Cardiovascular Surgery

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Patients without renal function are living longer than in the past, and the provision of dialysis access is a growing problem. The distal end of the greater saphenous vein can be anastomosed to the femoral artery, creating a transposed saphenous vein thigh arteriovenous fistula, which offers the theoretical advantages of autologous conduit and a native venous ‘anastomosis.’ This is a rarely performed procedure, however, in part because of the morbidity of vein harvest and the risk of groin infection. We have been favorably impressed by the reduction in morbidity and wound infection following endoscopic vein harvest for lower extremity bypass, and believe that the success of this technique merits a reevaluation of this procedure.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The greater saphenous vein can be used locally as a thigh saphenofemoral loop [1][2][3][4][5]. This is a rarely performed procedure, however, in part.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Transposed Saphenous Vein Arteriovenous Fistula Revisited: New Technology for an Old Idea

Illig

Orloff

Lyden

et al. 2002

Cardiovascular Surgery

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show abstract

“…The original technique involves the removal of a segment of GSV from the thigh and its placement in the anterior forearm subcutaneously, as a loop, anastomosed to the brachial artery and vein at the elbow crease (3). The subcutaneous saphenous vein loop placed in the thigh and anastomosed to the common femoral artery was described a decade later (5, 6). The latter technique was associated with inferior results and several complications (7) and fell into disrepute.…”

Section: Saphenous Vein Arteriovenous Fistulaementioning

confidence: 99%

Lower Limb Access

Wilmink

2014

J Vasc Access

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Lower limb vascular access is used as an access site in patients in whom all upper limb possibilities for arteriovenous access creation are exhausted or with bilateral upper limb central vein occlusions. Autologous arteriovenous fistulae (AVF) using the greater saphenous vein have disappointing results apart from the isolated success. Autologous AVF using the femoral vein transposition have good results both in terms of long-term patency and are associated with a 10-fold reduction in infection risk compared with arteriovenous grafts (AVGs). However, a femoral vein transposition is a major undertaking and is associated with an increased risk of ischaemic complications. It is not a good option for patients with established peripheral arterial disease, but may be a good alternative for the younger patient with a high infection risk. The type of lower-extremity vascular access should be carefully tailored to the individual patient.

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Prospective study of dialysis fistulas: Problem patients and their treatment

Reilly

Wood

Bell

1982

Journal of British Surgery

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With an increasing number of patients on maintenance haemodialysis treatment, providing satisfactory, long-lasting vascular access becomes critically important. There are a large number of reports of the relative success rates of various forms of vascular access, but there is general agreement that the Brescia-Cimino wrist fistula ( I ) is the most satisfactory. For the patient whose wrist fistula has failed, the surgeon has a choice of reconstructing the fistula when possible, constructing another fistula in the contralateral wrist, a brachial fistula (2) or inserting a graft of biological or synthetic origin. Grafts can be autologous (3) or allogeneic vein (4), umbilical vein ( 5 ) , bovine carotid artery (6) or synthetics such as polytetrafluoroethylene (PTFE) (7) and Dacron (8). Experience has shown that long term results are poor for vein loops (9, 10) and bovine heterografts ( 1 I), although with aggressive treatment of the frequent complications of bovine grafts, it is possible to achieve a 2-year patency rate of 77 per cent (12). Umbilical vein is relatively untried, though a I-year patency rate of 50 per cent has been reported (13). Patency rates for PTFE vary from 62 per cent at I year (14) to 83 per cent (15). Reports of long term patency for PTFE are harder to find; a 2-year patency rate of 76 per cent has been reported (10) and a 3-year patency rate of 63 per cent (10).The difficulty in drawing any conclusions from these studies is that the selection criteria are unknown-grafts have a greater patency rate if inserted as a primary procedure rather than in patients whose access sites are nearing exhaustion. The first aim of the present study was to examine the need for more complex procedures than simple arteriovenous fistulas in a population without previous surgery. Thus, all patients undergoing firsttime fistula operations have been studied, rather than all fistulas, regardless of whether they were first, second or subsequent procedures. The second aim of the study was to attempt to correlate fistula failure with possible aetiological factors, in the hope of predicting those likely to have subsequent thrombotic problems. Patients and methodsBetween January 1976 and May 1981 157 consecutive patients in chronic renal failure requiring access procedures were accepted on to the dialysis programme. Six patients were excluded from analysis because of previous fistula operations elsewhere. One hundred and forty-eight patients had a first-time wrist fistula constructed, 2 patients had an exploration of the wrist revealing no suitable vessels and 1 patient had a primary brachial fistula due to bilateral cephalic cutdowns in the past. Five patients with functioning fistulas were excluded due to inadequate data; 3 were transferred to other units and 2 died. Using actuarial analysis (16). fistula patency curves were calculated for the remaining 145 patients undergoing an attempt at a first-time wrist fistula. This included the two patients undergoing an exploration of the wrist to avoid biasing the results favo...

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Saphenous vein loop fistula in the thigh for maintenance hemodialysis

Cited by 13 publications

References 5 publications

Transposed Saphenous Vein Arteriovenous Fistula Revisited: New Technology for an Old Idea

Transposed Saphenous Vein Arteriovenous Fistula Revisited: New Technology for an Old Idea

Lower Limb Access

Prospective study of dialysis fistulas: Problem patients and their treatment

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