Document Detail


Ultrasound guided brachial arterial angioplasty during the creation of a radio-cephalic arteriovenous fistula: a case report.
MedLine Citation:
PMID:  16596528     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CASE REPORT: A 76-year-old diabetic male patient, on hemodialysis (HD) for 15 months, presented extensive thrombosis of the radio-cephalic AVF at the right arm, which had lasted for about 10 days. Ultrasound examination showed a 40% brachial artery stenosis with eccentric calcified plaque. The stenosis was localized about 1.5 cm before the artery bifurcation. The brachial artery diameter was 0.45 cm before and 0.26 cm at the level of the stenosis, the latter being 0.45 cm long. At the left wrist, under local anesthesia, the radial artery and the cephalic vein were exposed; the radial artery was then longitudinally incised for 7-8 mm in the area selected to create the AVF. A 6 Fr introducer, a metallic guide wire and a catheter for angioplasty were inserted one after the other in the radial artery. When the correct position of the angioplasty catheter in the stenotic area was established by ultrasound examination, the balloon was blown up to 13 atm for 35 sec, reducing the stenosis from 40-20%. Finally, a side-to-side radio-cephalic fistula was created, legating the distal vein. The AVF was used for HD after 3 weeks. The follow-up at 6 months demonstrated fair access performance and it was used without problems. Our satisfactory experience suggests that ultrasound guided angioplasty of brachial artery stenosis, performed simultaneously with surgical AVF creation, is possibly a successful procedure. This technique reduces the risk of early AVF failure and also allows, when required, stent implantation.
Authors:
M Napoli; A Montinaro; F Russo; A Valletta; A De Pascalis; S Proia; M Aprile; L Alfonso; P Patruno; E Buongiorno
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The journal of vascular access     Volume:  7     ISSN:  1129-7298     ISO Abbreviation:  J Vasc Access     Publication Date:    2006 Jan-Mar
Date Detail:
Created Date:  2006-04-05     Completed Date:  2006-08-29     Revised Date:  2013-05-20    
Medline Journal Info:
Nlm Unique ID:  100940729     Medline TA:  J Vasc Access     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  38-42     Citation Subset:  IM    
Affiliation:
Department of Nephrology, Dialysis and Kidney Transplantation, V. Fazzi Hospital, Lecce, Italy. marcellonapoli@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon*
Arterial Occlusive Diseases / therapy*,  ultrasonography
Arteriovenous Shunt, Surgical*
Brachial Artery / ultrasonography*
Constriction, Pathologic / ultrasonography
Humans
Male
Postoperative Complications*
Renal Dialysis / methods
Ultrasonography, Interventional*
Vascular Patency

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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