Arteriovenous fistula construction in the thigh with transposed superficial femoral vein: Our initial experience

Gradman, Wayne S.; Cohen, William N.; Haji-Aghaii, Massoud

doi:10.1067/mva.2001.115000

Cited by 99 publications

(83 citation statements)

References 12 publications

(12 reference statements)

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“…The cumulative primary and secondary fistula patency rates were 78% and 73% at 6 and 12 months and 91% and 86% at 6 and 12 months, respectively. One patient needed above knee amputation for acute compartment syndrome, and eight patients required a second surgery for distal limb ischemia (14,15). Rueda et al (16) reported 10 patients with tFV LE-AVF accesses, and none had a lower extremity ischemic event.…”

Section: Transposed Femoral Vein Le-avfmentioning

confidence: 99%

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Lower Extremity Permanent Dialysis Vascular Access

Parekh

Niyyar

Vachharajani

2016

CJASN

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Hemodialysis remains the most commonly used RRT option around the world. Technological advances, superior access to care, and better quality of care have led to overall improvement in survival of patients on long-term hemodialysis. Maintaining a functioning upper extremity vascular access for a prolonged duration continues to remain a challenge for dialysis providers. Frequently encountered difficulties in clinical practice include (1) a high incidence of central venous catheter-related central vein stenosis and (2) limited options for creating a functioning upper extremity permanent arteriovenous access. Lack of surgical skills, fear of complications, and limited involvement of the treating nephrologists in the decision-making process are some of the reasons why lower extremity permanent dialysis access remains an infrequently used option. Similar to upper extremity vascular access options, lower extremity arteriovenous fistula remains a preferred access over arteriovenous synthetic graft. The use of femoral tunneled catheter as a long-term access should be avoided as far as possible, especially with the availability of newer graft-catheter hybrid devices. Our review provides a summary of clinical evidence published in surgical, radiology, and nephrology literature highlighting the pros and cons of different types of lower extremity permanent dialysis access.

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Section: Transposed Femoral Vein Le-avfmentioning

confidence: 99%

“…Gradman et al (14,15) reported a low thrombosis rate in 25 patients with transposed superficial femoral vein (tFV) AVF with mean follow-up of 9.1 months. The cumulative primary and secondary fistula patency rates were 78% and 73% at 6 and 12 months and 91% and 86% at 6 and 12 months, respectively.…”

Section: Transposed Femoral Vein Le-avfmentioning

confidence: 99%

Lower Extremity Permanent Dialysis Vascular Access

Parekh

Niyyar

Vachharajani

2016

CJASN

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“…However, if the upper limb use is not appropriate, axillary-axillary AV access (necklace graft) (25), superficial femoral vein transposition (26), axillary artery to right atrial graft (27), hemodialysis reliable outflow graft (28), and femoral AV graft could be used as alternative choices for vascular access (19)(20)(21). Autogenous AV fistula or graft AV fistula are available for femoral AV access, although the former is not preferred because of wide incision and associated complications (19,29,30).…”

Section: Discussionmentioning

confidence: 99%

Percutaneous transluminal angioplasty for dysfunctional femoral hemodialysis graft

Kim²,

Goo³

et al. 2015

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSE We aimed to evaluate the safety and effectiveness of percutaneous transluminal angioplasty (PTA) for dysfunctional femoral arteriovenous graft and analyze clinical or anatomic predictors of graft patency. METHODSThe records of 45 patients who underwent PTA or thromboaspiration for dysfunctional or thrombosed femoral arteriovenous graft from 2005 to 2012 were reviewed retrospectively. Primary and secondary patency rates were determined at three, six, and 12 months after PTA. The primary patency rate was analyzed according to the presence of diabetes mellitus, graft age from the time of creation to the first intervention (<12 months or ≥12 months), presence of thrombus, shape of graft (U-shape vs. straight-shape), anastomosis type of graft (femoral-femoral vs. femoral-saphenous), location of stenosis (central vs. peripheral), length of stenosis (<2 cm vs. ≥2 cm), degree of stenosis severity (<70% vs. ≥70%), and stent insertion. RESULTSA total of 124 PTAs were performed in 45 patients. The primary patency rate at three, six, and 12 months was 84.8%, 63.6%, and 24.2%, respectively. The secondary patency rate at three, six, and 12 months was 95.2%, 95.2%, and 85.7%, respectively. The mean duration of primary and secondary patency was 13.2 and 35.7 months, respectively. No significant clinical or anatomical predictors of primary patency could be identified. Stent placement had a negative effect on primary patency. CONCLUSION PTA is a safe and effective treatment for dysfunctional femoral arteriovenous grafts. Stent placement seems to improve technical success, but does not enhance the primary patency rate of dysfunctional femoral arteriovenous grafts.

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“…Subsequently, autologous veins were used for constructing AVFs with transposed basilic (22) or cephalic veins in the upper limb and the great saphenous vein to form a loop in the groin, anastomosing the free end, in an end-to-side fashion, to the superficial femoral artery (23). The transposition of the superficial femoral vein appears to be burdened by several complications (24). In the early 1980s the use of optical magnification and microvascular instruments was underlined as helpful for constructing the VA (25).…”

Section: Arteriovenous Fistulas With Native Vesselsmentioning

confidence: 99%

The endless history of vascular access: a surgeon's perspective

Berardinelli

2006

J Vasc Access

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Arteriovenous fistula construction in the thigh with transposed superficial femoral vein: Our initial experience

Cited by 99 publications

References 12 publications

Lower Extremity Permanent Dialysis Vascular Access

Lower Extremity Permanent Dialysis Vascular Access

Percutaneous transluminal angioplasty for dysfunctional femoral hemodialysis graft

The endless history of vascular access: a surgeon's perspective

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