Cervical Arteriovenous Fistulae for Maintenance Hemodialysis

Abstract

Four patients with a paucity of peripheralveins had cervical arteriovenous fistulae created, utilizing the external jugular vein and either the superior thyroid artery or the external carotid artery. The fistulae provided a reasonably adequate solution for maintenance hemodialysis in these patients with chronic renal failure.

Tertiary Vascular Access Surgery for Chronic Hemodialysis

“…Exotic primary fistula construction is limited by the need for an accessible venous bed that can mature and by the propensity for proximal AV fistulae of larger vessels to steal too much blood from the distal circulation. Shepherd et al, in 1973, described several cervical AV fistulae utilizing the external carotid artery or any of its larger named branches (4 mm or larger) to anastomose directly end-to-end, with the external jugular vein (13) (Fig. 10).…”

Unusual Sites for Hemodialysis Vascular Access Construction and Catheter Placement: A Review

“…External jugular veins have been described as a source for venous outflow for external carotid or superior thyroid arteries (27). In this configuration, the arteriovenous anastomosis may use an end-to-end construction.…”

“…Due to its short length, the fistula accommodates only the inflow needle (arterial needle) to draw blood from it. Blood returns to the patient via a large intravenous line in a peripheral vein (27). The poor cervical fistula blood flow often leads to a treatment duration longer than normal (27).…”

ΑΙΜΟΔΥΝΑΜΙΚΗ ΜΕΛΕΤΗ ΤΗΣ ΤΑΥΤΟΧΡΟΝΗΣ ΔΗΜΙΟΥΡΓΙΑΣ ΕΞΩΤΕΡΙΚΗΣ (SHUNT) & ΕΣΩΤΕΡΙΚΗΣ(FISTULA) ΑΡΤΗΡΙΟΦΛΕΒΙΚΗΣ ΕΠΙΚΟΙΝΩΝΙΑΣ ΣΤΑ ΜΗΡΙΑΙΑ ΑΓΓΕΙΑ ΣΚΥΛΟΥ (ΠΕΙΡΑΜΑΤΙΚΗ ΕΡΓΑΣΙΑ)

“…Τέλος, σπάνια, σε παιδιά χρησιμοποιήθηκαν η άνω θυρεοειδική αρ τηρία ή η έξω καρωτίδα και η έξω σφαγίτιδα φλέβα για Α-Φ αναστόμωση (Shepherd, Magalhaer, Economou 1973).…”