Browse > Article

Arteriovenous Fistula Formation with Prosthetic Graft Using the Vena Comitantes as a Venous Outflow  

Lee, Gun (Department of Thracic and Cardiovascular Surgery, Bundang CHA General Hospital, College of Medicine, Pochon CHA University)
Lim, Chang-Young (Department of Thracic and Cardiovascular Surgery, Bundang CHA General Hospital, College of Medicine, Pochon CHA University)
Lee, Hyeon-Jae (Department of Thracic and Cardiovascular Surgery, Bundang CHA General Hospital, College of Medicine, Pochon CHA University)
Publication Information
Journal of Chest Surgery / v.42, no.1, 2009 , pp. 41-45 More about this Journal
Abstract
Background: Arteriovenous fistula formation is not always easy to perform in hemodialysis patients because of poor preservation of veins due to repeated venipuncture and cannulation. We analyzed the patency rate and complications of prosthetic arteriovenous fistulas using the vena comitantes as a venous outflow in the antecubital fossa, which are protected from venipuncture. Material and Method: Between January 2006 and June 2008, 12 patients underwent prosthetic arteriovenous fistula formation using the vena comitantes as a venous outflow. Arterial inflow was via the brachial artery and the graft was placed in a loop fashion. The male-to-female ratio was 7 : 5 and the mean age was $59{\pm}14$ years. Six patients had diabetes mellitus and 10 patients had hypertension. Result: There were no complications, such as a graft infection or bleeding. Five patients showed postoperative stenosis at an average of 3 months. The primary patency rate was 75.0, 65.6, and 52.2% at 3, 6, and 12 months, respectively. All the patients with stenosis were able to continue hemodialysis after intervention therapy. The secondary patency rate was 100% at 12 months. Conclusion: Creation of a prosthetic arteriovenous fistula using uninjured vena comitantes resulted in a good patency rate and this vein may become a substitute for inappropriate superficial veins.
Keywords
Shunts; Arteriovenous fistula; Hemodialysis;
Citations & Related Records
연도 인용수 순위
  • Reference
1 ESRD Registry Committee, Korean Society of Nephrology. Current renal replacement therapy in Korea-Insan memorial dialysis registry 2006. Korean J Nephrol 2006;25:S425-57
2 Skandolas I, Chatzibaloglou A, Tsalis K, et al. Prosthetic graft placement using the deep forearm veins in hemodialysis patients: a preliminary report. Nephron 2000;85: 346-7   DOI   ScienceOn
3 Pisoni RL, Young EW, Dykstra DM, et al. Vascular access use in Europe and the United states: results from DOPPS. Kidney Int 2002;61:305-16   DOI   ScienceOn
4 The Vascular Access Work Group. NKF-DOQI clinical practice guidelines for vascular access. National kidney foundation- dialysis outcomes quality initiative. Am J Kidney Dis 1997;30(Suppl 3):S150-90
5 Brescia MJ, Cimino JE, Appel K, Hurwich BJ. Chronic hemodialysis using venepuncture and a surgically created arteriovenous fistula. N Engl J Med 1966;275:1089-92   DOI   ScienceOn
6 Jung HW, Lim YH, Lee YJ, et al. The patency rate of hemodilysis vascular access and the analysis of patency- related factors: comparison of native arteriovenous fistula with arteriovenous graft, single center study. Korean J Nephrol 2008;27:70-7
7 Vascular Access 2006 Work Group. Clinical practice guidelines for vascular access. Am J Kidney Dis 2006;48(Suppl 1): S176-247   DOI   ScienceOn
8 Quinton WE, Dillard D, Scribner BH. Cannulation of blood vessels for prolonged hemodialysis. Trans Am Soc Artif Intern Organs 1960;6:104-13
9 Fitzgerald JT, Schanzer A, Chin AI, McVicar JP, Perez RV, Tromppmann C. Outcomes of upper arm arteriovenous fistulas for maintenance hemodialysis access. Arch Surg 2004;139:201-8   DOI   ScienceOn
10 Benedetti E, Del Pino A, Cintron J, Duarte B. New method of creating an arteriovenous graft access. Am J Surg 1996; 17:369-70
11 Won TH, Sun KM, Ji WJ, et al. Early result of arteriovenous graft with deep forearm veins as an outflow in hemodialysis patients. Ann Vasc Surg 2002;16:501-4   DOI   ScienceOn