| Autor: |
M, Porcellini, L, Selvetella, P, De Rosa, M, Baldassarre, A, Bauleo, R, Capasso |
| Rok vydání: |
1997 |
| Předmět: |
|
| Zdroj: |
Il Giornale di chirurgia. 18(1-2) |
| ISSN: |
0391-9005 |
| Popis: |
Among complications of vascular access operations, symptomatic steal syndrome is uncommon, but may lead to ischemia of the hand. Between 1983 and 1995, 5 patients with hemodialysis fistulas presented rest pain of finger necrosis with a wrist-brachial index of 0.56 (range 0.35 to 0.63) improving to 0.96 (range 0.72 to 1.05) after digital pressure of the fistula. Ligation of distal radial artery was performed in 3 patients with side-to-end radiocephalic fistula, while basilic vein was distally ligated in a case of side-to-side brachiobasilic fistula. A vein "banding" procedure reduce fistula flow and improved distal perfusion in one patient, while a true venous aneurysm of the cephalic vein was treated by excision and replacement with a tapered PTFE graft. Hemodynamic assessment is required during surgical correction, but it may also be useful in pre- and intra-operative evaluation of patients undergoing therapeutical AVFs to prevent arterial insufficiency of the hand. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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