Arteriovenous Access superficialization: A New Technique and Review of Options

Fontenot, Danielle T.; Tanious, Adam; Arhuidese, Isibor; Chauhan, Yusuf; Stafford, Alicia M.; Illig, Karl A.

doi:10.1016/j.avsg.2020.05.020

Cited by 12 publications

(2 citation statements)

References 17 publications

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“…Increased adipose tissue under the skin surface will cause difficulty in accessing blood. 15 The difference between the results of this study and the existing theory may be due to the small study sample.…”

Section: Methodscontrasting

confidence: 72%

Differences in Arteriovenous Fistula Maturation between Diabetes Mellitus and Non-Diabetes Mellitus in Chronic Renal Failure Patients in Padang

2021

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Background: Arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis (HD). Several factors can affect AVF maturity, such as diabetes. This study aims to determine the differences in the maturation of arteriovenous fistulas between diabetes mellitus and non-diabetes mellitus in patients with chronic kidney failure in Padang. Methods: This was a comparative cross-sectional study of patients with chronic kidney failure who underwent arteriovenous fistula surgery in Padang. The sampling technique in this study was consecutive sampling. The analysis was carried out using statistical analysis according to the existing data scale and using SPSS software. Results: This study involved 46 patients with chronic kidney failure who underwent arteriovenous fistula surgery in Padang, of which 23 patients with diabetes mellitus and 23 patients with non-diabetes mellitus. The diameter of the arteriovenous fistula between diabetes mellitus and non-diabetes mellitus in patients with chronic renal failure had a significant difference (p<0.05). There was no significant difference in flow, depth, and maturation of arteriovenous fistulas in patients with diabetes mellitus and non-diabetes mellitus with chronic renal failure. Conclusion: There is no difference in the maturation of arteriovenous fistula between patients with diabetes mellitus and non-diabetes mellitus

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Section: Methodscontrasting

confidence: 72%

Differences in Arteriovenous Fistula Maturation between Diabetes Mellitus and Non-Diabetes Mellitus in Chronic Renal Failure Patients in Padang

2021

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“…In this situation, it should be superficialized, using any one of several techniques. 23 Consideration can be given to endovascular or surgical occlusion of a vein that is felt to be significantly competing with the cephalic, but this may not be necessary. • • Second, the cephalic vein has inadequate flow, but the brachial or basilic vein has adequate flow and size.…”

Section: The Role Of Surgery For Maturation and Assisted Maturation Following Endo-and Perc-avf Creationmentioning

confidence: 99%

The role of surgery for assisted maturation after endovascular and percutaneous arteriovenous fistula creation

et al. 2020

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Even in the best of circumstances, a significant number of patients will require adjunctive endovascular and/or surgical revision prior to achieving functional patency after endovascular or percutaneous AVF creation, at least within the United States. This rate appears to be higher after percutaneous AVF than after endovascular AVF, although because published reports of the former are mostly derived from American experience and those of the latter derived from experience outside the United States, it is unclear whether these differences are due to the technique itself or cultural and/or anatomic differences in dialysis access practices and patient populations. If arterial inflow is poor, this should be corrected first. When flow is adequate (perhaps 900 cc/min) but no single vein is cannulatable, a dominant suitable vein can be superficialized or transposed. If no suitable vein is dominant (most accurately assessed by using an intraoperative flowmeter), the best vein can be used, with or without occlusion of the other veins or reimplantation into the brachial artery. Finally, if the original anastomosis remains the sole supply to the cannulated vein, the original fistula has achieved assisted primary maturation (and assisted primary patency continues), while if a new arteriovenous anastomosis has been constructed, the original fistula has failed. We point out that for this reason as well as to best utilize the upper arm for later access, endovascular and percutaneous AVFs should be constructed and maintained within an atmosphere where both surgeons and non-surgeons work together on the overall access plan.

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