The Upper Arm Arterio-Venous Fistula—an Alternative for Vascular Access in Haemodialysis

Gade, John; Aabech, J; Hansen, Rasmus Hvass

doi:10.3109/00365599509180550

Cited by 9 publications

(4 citation statements)

References 9 publications

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“…In this type of anastomoses, the rates of remaining patent of anastomoses created in the proximity of the upper extremities are found to be higher than those made in the distal upper extremities. In anastomoses made at the distal upper extremities, (Brescia-Cimino; snuff-box) patency rates in the first 6 postoperative months are reported as 66% and 70%, respectively [7,12,14,15]. In our study the patency rate at the end of the first 6 months was 89%.…”

Section: Discussionmentioning

confidence: 44%

Evaluation of arteriovenous fistulas made with the diamond-shaped anastomosis technique

et al. 2012

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SummaryBackgroundObtaining vascular access suitable for long-term use in hemodialysis patients is of utmost importance. In these patients, autogenous methods are generally used for access. There are various techniques for obtaining autogenous access in hemodialysis patients.Material/MethodsOur objective was to evaluate the outcomes of the “diamond-shaped anastomosis” technique used as a surgical technique during the creation of arteriovenous fistulas in patients with chronic renal failure. We randomly selected and retrospectively examined 67 patients on whom the “diamond-shaped anastomosis” technique had been performed.ResultsWe found an 89% patency rate in the 67 randomly selected patients on whom we applied this technique in the early stage (first 6 months).ConclusionsMaintaining fistula patency in the early postoperative period is important in fistula functioning. The diamond-shaped anastomosis is a simple technique with proven efficiency. This method can be applied in all situations and contributes to postoperative early stage latency.

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Section: Discussionmentioning

confidence: 44%

Evaluation of arteriovenous fistulas made with the diamond-shaped anastomosis technique

et al. 2012

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“…Higly occlusion rates of AVF were reported in ESRD patients in the literature [16,17]. Gade et al have reported that the overall patency rate for AVF used for haemodialysis was 50% after one year and 38% after two years in their study after arterio-venous fistula prosedure [16].…”

mentioning

confidence: 85%

“…Gade et al have reported that the overall patency rate for AVF used for haemodialysis was 50% after one year and 38% after two years in their study after arterio-venous fistula prosedure [16]. They have suggested that the upper arm arteriovenous fistula can serve as a second choice, when a radio-cephalic fistula fails.…”

mentioning

confidence: 99%

Assesment of Radial Artery by Means of Doppler Ultrasonography and Soft Tissue Roentgenogram in End-Stage Renal Disease Patients

Abacilar¹,

Duman²,

Dogan³

2014

WJCS

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Background: Although the radial artery (RA) is mostly selected for the creating of arterio-venous fistula (AVF) in end-stage renal disease patients (ESRDP), it still represents a suitable site to simply assess systemic calcification. Our goal of this study was to research the RA before the arteriovenous fistula creation in ESRDP and evaluate the risk factor determinants. Material and Methods: The RA has been determined to estimate vascular calcification in 67 ESRDPs on dialysis by doppler ultrasonography (USG). If there was any pathologic conditions, direct examination of the forehand soft tissue roentgenograms as a simply method was made. Preoperative spectral Doppler sonography measured radial artery peak systolic velocity during tight fist clenching for 3 minutes and after fist relaxation. Vessel diameters and peak systolic velocity were assessed for predictive value based on subsequent fistula adequacy. RA calcification was scored from Grade 0 which was defined as no calcification to Grade 4 which was described as severe calcification from proximal to distal end of RA. Results: Doppler USG has shown that the major or minor RA calcification was detected in 11 patients (16.5%). In these patients, direct roentgenogram also demonstrated RA calcific disease. Total and LDL cholesterol levels, gender and smoking status have no influence on calcification scores. When the dialysis periods are concerned, there was no correlation with the RA calcification. Serum calcium and phosphate levels, rather than calcium-phosphate products, and age were correlated with high calcification scores. The highest prevalence of RA calcification was also found in diabetic group. Conclusion: Our data indicate that RA calcification is highly prevalent among ESRDP, with the highest prevalence among diabetics. The RA was used as an A-V fistual creation in ESRDPs, which may be risky since the calcification percentage is higher. Therefore, a simple roentgenographic survey may help to identify patients with severe calcified RA. Because our roengenographyc results were correlated with doppler USG, it can be used to determine RA calcific disease before the arteriovenous fistula creation.

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“…If a wrist fistula is not possible, options at the elbow (brachiocephalic, transposed brachiobasilic, autogenous vein transfers) can be pursued [3][4][5]. When the elbow or antecubital veins cannot be used to create an AVF, the end of the cephalic vein can be mobilized and tunneled for an anastomosis with the proximal, aboveelbow brachial artery.…”

Section: Choice Of Access Type: Why Avf?mentioning

confidence: 99%

Preventing Vascular Access Dysfunction: Which Policy to Follow

Besarab¹

2002

Blood Purif

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In the USA, three Clinical Performance Measures are currently in place: increasing the number of autologous arteriovenous fistulas (AVFs) among incident hemodialysis patients to 50% and to 40% in prevalent hemodialysis patients; to foster the surveillance of accesses with pre-emptive correction of problems before accesses thrombose or fail, and to reduce the use of catheters in prevalent patients to less than 10%. Reduction of catheters will automatically result from initiatives that increase the construction of AVFs and pre-emptive monitoring and surveillance of accesses for dysfunction. Therefore, policies that promote the latter two vascular access aspects are most important to develop and follow. Of these two, however, the most impact will be made by promoting a policy to increase AVF creation in the timeliest manner possible. Strategies and resources needed to achieve these policies are presented. The need for a team approach is emphasized.

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The Upper Arm Arterio-Venous Fistula—an Alternative for Vascular Access in Haemodialysis

Cited by 9 publications

References 9 publications

Evaluation of arteriovenous fistulas made with the diamond-shaped anastomosis technique

Evaluation of arteriovenous fistulas made with the diamond-shaped anastomosis technique

Assesment of Radial Artery by Means of Doppler Ultrasonography and Soft Tissue Roentgenogram in End-Stage Renal Disease Patients

Preventing Vascular Access Dysfunction: Which Policy to Follow

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