| Autor: |
Ghaith Almhanni, MD, Indrani Sen, MBBS, Sai Vang, PAC, Shaun Marczak, PAC, Kirk Herzog, PAC, Mark Twesme, PAC, Matthew Ryba, PAC, Gloria Krueger, PAC, Rachel Jack, CNP, Jason Beckermann, MD, Thomas Carmody, MD, Tiziano Tallarita, MD |
| Jazyk: |
angličtina |
| Rok vydání: |
2024 |
| Předmět: |
|
| Zdroj: |
Journal of Vascular Surgery Cases and Innovative Techniques, Vol 10, Iss 2, Pp 101382- (2024) |
| Druh dokumentu: |
article |
| ISSN: |
2468-4287 |
| DOI: |
10.1016/j.jvscit.2023.101382 |
| Popis: |
Endoscopic vein harvest remains underused in single-stage brachial-basilic arteriovenous fistula creation. We analyzed our results with the use of this technique in a cohort of predominantly obese (body mass index ≥30 kg/m2) patients. Demographics, intraoperative details, and outcomes for all consecutive patients who underwent single-stage endoscopic-assisted brachial-basilic arteriovenous fistula creation between 2020 and 2022 at a single institute were analyzed retrospectively. The primary outcomes were technical success, fistula maturation, and primary assisted and secondary patency rates. Of the 11 patients (7 men; mean age, 62 ± 11.6 years), 7 (64%) already required dialysis at referral. The mean body mass index was 34 ± 7 kg/m2, 64% were obese, and an additional 27% were overweight. The medical comorbidities included hypertension in 11 patients (100%), diabetes in 7 (64%), and smoking in 8 (73%). Technical success was 100%, with no intraoperative complications. The median procedural length was 231 minutes (range, 183-302 minutes). Early complications in two patients (18%) included bleeding of the venous side branch requiring ligation and the loss of thrill requiring division of a tethering bridge of a large tributary. The maturation rate was 100%, and the brachial-basilic arteriovenous fistula was successfully accessed in all patients who required dialysis. At 12 months, the primary assisted and secondary patency rates were 90% ± 10% and 100%, respectively. Reintervention in seven patients (64%) included successful angioplasty in four, thrombectomy in two, and aneurysm resection with an interposition graft in one patient. Endoscopic vein harvest can be used for single-stage brachial-basilic arteriovenous fistula creation with good technical success and favorable maturation and patency rates, even for obese patients. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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