Use of the subcutaneous venous network of the forearm to create an arteriovenous fistula
| Autor: | Marian Klinger, Jerzy Garcarek, Mariusz Kusztal, Wacław Weyde, Krzysztof Letachowicz, Beata Strempska, Tomasz Gołębiowski, Waldemar Letachowicz |
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| Rok vydání: | 2015 |
| Předmět: |
Cephalic vein
medicine.medical_specialty medicine.diagnostic_test business.industry Fistula Arteriovenous fistula Hematology medicine.disease Surgery medicine.anatomical_structure Forearm Nephrology medicine.artery Angiography cardiovascular system medicine Radiology Radial artery Vein business Lower limbs venous ultrasonography |
| Zdroj: | Hemodialysis International. 19:E24-E28 |
| ISSN: | 1492-7535 |
| DOI: | 10.1111/hdi.12304 |
| Popis: | The reconstruction of vascular access in patients with kidney allograft failure is a challenging problem. A case of a 62-year-old man with transplanted kidney insufficiency is described. The patient was initially dialyzed with a wrist radial-cephalic arteriovenous fistula. In the post-transplantation period, the enormously dilated venous part of the anastomosis was ligated and the part of the vein suspected of being the source of bacteremia was excised. The man was referred to our department due to kidney allograft failure for vascular access creation. During preoperative assessment, we unexpectedly found a soft thrill on the forearm. Doppler ultrasound confirmed fistula patency, although the blood supply was not sufficient to perform dialysis. Angiography showed the blood flow from the radial artery to the cephalic vein, through a complicated vessel system consisting of inter alia a dilated vein of the subcutaneous venous network. We successfully used this vein as the vascular access outflow for fistula recreation. In conclusion, making use of veins of the subcutaneous venous network of the forearm for creation of a native fistula should be considered in selected cases. |
| Databáze: | OpenAIRE |
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