The past and the future of vascular access surgery: Creation of percutaneous arteriovenous fistula using Ellipsys vascular access system in a patient with previous ipsilateral Scribner-shunt
| Autor: | Klaus Konner, Robert Shahverdyan, Vladimir Matoussevitch |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Percutaneous Fistula Vascular access Arteriovenous fistula 030204 cardiovascular system & hematology 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Arteriovenous Shunt Surgical Renal Dialysis medicine Humans End-stage kidney disease Hemodialysis access Vascular Patency Aged Retrospective Studies business.industry medicine.disease Shunt (medical) Surgery Treatment Outcome Nephrology Arteriovenous Fistula Female business Angioplasty Balloon |
| Zdroj: | The journal of vascular access. 22(6) |
| ISSN: | 1724-6032 |
| Popis: | Background: Sixty years after the first description of Scribner-shunt, and 54 years after publication of the first radio-cephalic arterio-venous fistula (AVF), endovascular percutaneous AVF (pAVF) was introduced. We report a successful case of Ellipsys-pAVF creation and use for hemodialysis in a patient with a previous ipsilateral Scribner-shunt. Case: A 72-year old female patient with chronic kidney disease (CKD), previous right-sided Scribner-shunt and kidney transplant, underwent a successful creation of right-sided Ellipsys-pAVF. The procedure time was 12 min with intraoperative brachial artery volume flow of 720 ml/min. At 39 days, an ultrasound-guided balloon-angioplasty of the outflow cephalic vein stenosis was performed. Cannulations were started 41 days after the creation of pAVF. No additional interventions were required during the follow-up of 258 days with last follow-up volume flow of 1400 ml/min. Conclusions: This is the first report of the creation of pAVF in a patient with previous “traumatic” ipsilateral placement of a Scribner-shunt. It allows the creation of a small anastomosis in very short time, which can be successfully used for hemodialysis treatment on the same day, if necessary, and reduces the expected risk of high-flow AVF with associated peripheral steal and cardiac outcomes (especially in a patient with cardiomyopathy such this one). |
| Databáze: | OpenAIRE |
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