Document Detail

Exotic arteriovenous fistulas for hemodialysis.
MedLine Citation:
PMID:  15013301     Owner:  NLM     Status:  MEDLINE    
The rate of patients with exhausted upper extremity arteriovenous fistula (AVF) sites who have lost all chances for a conventional upper extremity AVF has been increasing in line with the general increase in the hemodialysis patient population. In this prospective study, we report the early and late follow-up results of "exotic" AVFs in which central veins are used for the outflow. Patients having no chance for an upper extremity AVF based on previous catheterization, surgical AVF history, detailed physical examination, and radiological assessment, were included in the study. Between June 1999 and January 2003, 27 central AVFs were created with a 6 mm synthetic vascular graft in 26 patients. The inflow artery was the proximal axillary artery in all except one. All but one operation was done by the same surgeon. The outflow vein was the internal jugular vein in 16 and infraclavicular axillary vein in 11 cases. One-year primary and secondary graft patency rates were 33.33 +/- 10.49 and 57.06 +/- 11.29, respectively. The early complications were facial edema and hemiparesis, both of which resolved spontaneously. The only late complication, pseudoaneursym, was treated by a graft interposition. In selected patients who have no suitable upper extremity vessels for an AVF, the central veins may be used with an acceptable success rate. Another advantage of this procedure is the avoidance of undesired femoral interventions; sometimes it may be the only opportunity and lifesaving for the patient.
S Hazinedaroğlu; F Karakayali; A Tüzüner; D Ayli; S Demirer; N Duman; M A Yerdel
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transplantation proceedings     Volume:  36     ISSN:  0041-1345     ISO Abbreviation:  Transplant. Proc.     Publication Date:    2004 Jan-Feb
Date Detail:
Created Date:  2004-03-11     Completed Date:  2004-10-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0243532     Medline TA:  Transplant Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  59-64     Citation Subset:  IM    
Department of Nephrology, Ankara University Medical School, Ankara, Turkey.
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MeSH Terms
Anesthesia, Local
Arteriovenous Shunt, Surgical / methods*,  mortality
Catheters, Indwelling
Renal Dialysis*
Survival Analysis
Time Factors

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