Axillo-iliac arteriovenous hemodialysis graft creation with an early cannulation device
| Autor: | Hugo Laparra-Escareno, Alejandra Lopez-Mendez, Adriana Torres-Machorro, Rene Lizola, Carlos A. Hinojosa, Zeniff Gomez-Arcive, Javier E. Anaya-Ayala, Cesar Cuen-Ojeda |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment 030232 urology & nephrology Biomedical Engineering Medicine (miscellaneous) 030204 cardiovascular system & hematology Anastomosis Balloon Catheterization Biomaterials Abdominal wall 03 medical and health sciences 0302 clinical medicine Arteriovenous Shunt Surgical Axillary artery Renal Dialysis Angioplasty medicine.artery medicine Humans Atrium (heart) Vein Vascular Patency business.industry Middle Aged Surgery Blood Vessel Prosthesis medicine.anatomical_structure Treatment Outcome Kidney Failure Chronic Female Hemodialysis Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs. 20(1) |
| ISSN: | 1619-0904 |
| Popis: | Exhaustion of superficial veins coupled with the presence of intrathoracic central venous occlusions remains a significant obstacle for hemodialysis access creation; complex arteriovenous graft (AVG) configurations have been described. The axillary-iliac AVG was first reported in 1987, and few authors have explored this access. We evaluated our experience with this AVG configuration utilizing the early cannulation (EC) graft Flixene™ (Atrium ™, Hudson, NH, USA). Eight patients (75 % men; mean age 37 ± 10 years) with End-Stage Renal Disease (ESRD) underwent axillo-iliac AVG creation with Flixene™ grafts; all had exhausted peripheral veins, occluded thoracic central veins, and inadequate femoral veins. Inflow from the axillary artery and outflow in iliocaval system was assessed prior to access creation. An axillary-to-common iliac AVG was constructed using a 6 mm (mm) EC graft and tunneled in the chest and abdominal wall. Eight grafts were implanted; all were patent after placement. Seven (88 %) were successfully used for hemodialysis within 72 h and one (12 %) within 96. During the mean follow-up of 6 months, 5 (62 %) patients underwent thrombectomy, 1 (12 %) of them had balloon angioplasty at the vein anastomosis, and 2 (25 %) grafts were removed secondary to infection. The remaining grafts are still functioning. Complications as high-output heart failure, steal syndrome and venous hypertension were not observed. Construction of axillo-iliac AVG with EC grafts in the setting of exhausted veins, occluded intrathoracic central veins and hostile groins, is a viable arteriovenous access alternative while avoiding central venous catheters. |
| Databáze: | OpenAIRE |
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