Surgical Treatment of Cephalic Arch Stenosis by Central Transposition of the Cephalic Vein

Sigala, Fragiska; Saßen, Regine; Kontis, Elissaios; Kiefhaber, Laura D; Förster, R.; Mickley, V.

doi:10.5301/jva.5000195

Cited by 28 publications

(20 citation statements)

References 17 publications

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“…[19][20][21] In this study, both transposition and bypass achieved higher patencies than endovascular interventions, and these findings are supported by other reports in the literature. Sigala et al 22 reported primary and secondary 1-year patency of 79% and 90% after cephalic vein transposition and also noted a low reintervention rate of 0.1 intervention per person-year of follow-up. In a prospective trial, Kian et al 23 reported that surgical transposition of the cephalic vein yields better patency rates.…”

Section: Discussionmentioning

confidence: 97%

Outcomes of intervention for cephalic arch stenosis in brachiocephalic arteriovenous fistulas

Hicks

Haidar

El-Sayed

2017

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 97%

Outcomes of intervention for cephalic arch stenosis in brachiocephalic arteriovenous fistulas

Hicks

Haidar

El-Sayed

2017

Journal of Vascular Surgery

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“…Como ya adelantamos, algunos autores han propuesto que se debe a características anatómicas propias del AVC y factores hemodinámicos, entre otras (Boghosian et al, 2014;Daoui & Asif. ;Hammes et al;Iimura et al;Jaberi et al;Sigala et al;Sivananthan et al). Nos centraremos fundamentalmente en los primeras.…”

Section: Resultsunclassified

“…Las fístulas arteriovenosas (FAVs) nativas son menos propensas al desarrollo de trombosis e infección que la utilización de prótesis y catéteres y son, por tanto, el gold standard para la confección de accesos vasculares permanentes (Ravani et al, 2013). Sin embargo, la estenosis de las mismas constituye aún una problemática común, determinando la disfunción del angioacceso y en consecuencia una hemodiálisis ineficaz (Sigala et al, 2014;Sivananthan et al, 2014).…”

Section: Introduccionunclassified

Estudio Cadavérico del Arco de la Vena Cefálica

et al. 2020

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RESUMEN: Dentro de las disfunciones de los angioaccesos, la estenosis del arco de la vena cefálica (AVC) juega un papel significativo. Existen características anatómicas del AVC que explican, en parte, este fenómeno. Todo esto obliga a un conocimiento profundo del AVC y sus principales variantes. Se disecaron 43 (n=43) axilas de cadáveres adultos fijados en solución en base a formol. Se registró: longitud del AVC (LAC), angulación del AVC respecto a la vena cefálica (AAC), tipo de terminación (simple o múltiple), presencia de afluentes y su número. LAC promedio 31,6 mm (rango 17-46 mm); AAC promedio 128,95° (rango 65-165°). En cuanto al tipo de terminación 41 (95,3 %) fueron simples, mientras que 2 casos (4,7 %) fueron de forma múltiple. Respecto a los afluentes, se encontraron en 42 de los casos (90,5 %). Se encontraron válvulas en 27 (62,8 %) de los casos. La longitud promedio del AVC fue de 31,6 mm, se dispuso en la mayoría de los casos en ángulo obtuso, presentando en la mayoría de los casos terminación de tipo simple. Además, en el 90,5 % se encontró afluentes que se agotaban en el AVC y en más de la mitad de los casos se encontraron válvulas. Se discuten las implicancias de estos hallazgos en la génesis de la disfunción de angioaccesos.

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“…Clinically, timely surgical correction provides much longer access patency in certain cases, such as the juxta-anastomotic stenosis and cephalic arch stenosis with frequent recurrence [ 12 , 13 ], and reduces unnecessary endovascular procedures, including angioplasty and stent deployment. The NKF-KDOQI guidelines recommended that patients should be re-evaluated for possible construction of a secondary fistula following each episode of access failure [ 14 ], and considered for surgical revision prior to stent deployment unless they have a surgically inaccessible lesion or contraindications for surgery [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Current treatment status and medical costs for hemodialysis vascular access based on analysis of the Korean Health Insurance Database

Lee

Song

et al. 2018

Korean J Intern Med

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Background/AimsThe Republic of Korea is a country where the hemodialysis population is growing rapidly. It is believed that the numbers of treatments related to vascular access-related complications are also increasing. This study investigated the current status of treatment and medical expenses for vascular access in Korean patients on hemodialysis.MethodsThis was a descriptive observational study. We inspected the insurance claims of patients with chronic kidney disease who underwent hemodialysis between January 2008 and December 2016. We calculated descriptive statistics of the frequencies and medical expenses of procedures for vascular access.ResultsThe national medical expenses for access-related treatment were 7.12 billion KRW (equivalent to 6.36 million USD) in 2008, and these expenses increased to 42.12 billion KRW (equivalent to 37.67 million USD) in 2016. The population of hemodialysis patients, the annual frequency of access-related procedures, and the total medical cost for access-related procedures increased by 1.6-, 2.6-, and 5.9-fold, respectively, over the past 9 years. The frequency and costs of access care increased as the number of patients on hemodialysis increased. The increase in vascular access-related costs has largely been driven by increased numbers of percutaneous angioplasty.ConclusionsThe increasing proportion of medical costs for percutaneous angioplasty represents a challenge in the management of end-stage renal disease in Korea. It is essential to identify the clinical and physiological aspects as well as anatomical abnormalities before planning angioplasty. A timely surgical correction could be a viable option to control the rapid growth of access-related medical expenses.

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Surgical Treatment of Cephalic Arch Stenosis by Central Transposition of the Cephalic Vein

Abstract: Primary 1-year access patency rates after CVT compare favorably with those after interventional treatment, and reintervention rates are lower. Frequently occurring prestenotic aneurysms could be repaired simultaneously. CVT should therefore be regarded as the treatment of choice for CAS.

Cited by 28 publications

References 17 publications

Outcomes of intervention for cephalic arch stenosis in brachiocephalic arteriovenous fistulas

Outcomes of intervention for cephalic arch stenosis in brachiocephalic arteriovenous fistulas

Estudio Cadavérico del Arco de la Vena Cefálica

Current treatment status and medical costs for hemodialysis vascular access based on analysis of the Korean Health Insurance Database

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