| Proximal radial artery ligation (PRAL) for reduction of flow in autogenous radial cephalic accesses for haemodialysis. | |
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MedLine Citation:
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PMID: 20359915 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Juxta-anastomosis proximal radial artery ligation (PRAL) is a new surgical technique for reduction of excessive blood flow of radial cephalic fistulas (RCFs). PATIENTS AND METHODS: This prospective study included 37 consecutive patients (eight children and 29 adults) who underwent PRAL of high-flow RCFs causing ischaemia (n = 2), aneurysmal degeneration of the vein (n = 14), and cardiac insufficiency (n = 7) or for prevention of cardiac overload (n = 14). Mean fistula age was 2.6 years for children and 7.4 years for adults. None had diabetes. Anatomical prerequisites (side-to-end anastomosis fistula and retrograde flow in the distal radial artery) were checked by ultrasound or angiography. Division and ligation of the juxta-anastomosis proximal radial artery were performed under regional anaesthesia. Patency following ligation was estimated according to the life table method. RESULTS: The success rate was 92% (34/37). The three failures included one excessive and two insufficient reductions of flow (<33%). Mean flow reduction rates were 50% in children and 53% in adults. Primary patency rates at 1 and 2 years were 88% +/- 6% and 74% +/- 9%, respectively. Secondary patency rates were 88% +/- 6% and 78% +/- 8%, respectively. CONCLUSION: PRAL is a simple, safe, and effective technique for reduction of flow in RCFs. |
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Authors:
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P Bourquelot; J Gaudric; L Turmel-Rodrigues; G Franco; O Van Laere; A Raynaud |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-03-31 |
Journal Detail:
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Title: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery Volume: 40 ISSN: 1532-2165 ISO Abbreviation: Eur J Vasc Endovasc Surg Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-07-06 Completed Date: 2010-08-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9512728 Medline TA: Eur J Vasc Endovasc Surg Country: England |
Other Details:
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Languages: eng Pagination: 94-9 Citation Subset: IM |
Copyright Information:
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Copyright 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved. |
Affiliation:
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Department of Angioaccess Surgery, Clinique Jouvenet, Paris, France. pbourquelot@sfav.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Anesthesia, Conduction Arteriovenous Shunt, Surgical / adverse effects* Blood Flow Velocity Brachiocephalic Veins / physiopathology, surgery* Cardiovascular Diseases / etiology, physiopathology, surgery*, ultrasonography Child Child, Preschool Female Humans Ligation Male Middle Aged Prospective Studies Radial Artery / physiopathology, surgery* Regional Blood Flow Renal Dialysis* Reoperation Time Factors Treatment Outcome Ultrasonography, Doppler, Color Vascular Patency Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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