Latero-lateral femoro-femoral arteriovenous fistula: a new surgical approach for hemodialysis patients with no vascular access

Acta Cirurgica Brasileira

Jesualdo Cerri¹  Eduardo Ramacciotti²  Marise Gomes²  Wagner Tedeschi Filho²  Carlos Eli Piccinato² 

[1] ,University Hospital Ribeirao Preto School of Medicine Department of Surgery and Anatomy

关键词: Arteriovenous Fistula;    Femoral Vein;    Femoral Artery;    Renal Dialysis;    Fístula Arteriovenosa;    Veia Femoral;    Artéria Femoral;    Diálise Renal;   

DOI  :  10.1590/S0102-86502011000100013

来源: SciELO

【 摘 要 】

Purpose: A new surgical approach for vascular access for hemodialysis using a latero-lateral arteriovenous fistula (AVF) in the thigh between the femoral artery (FA) and superficial femoral vein (SFV) transposed to the subcutaneous layer in patients with no other access options is described. Methods: Ten patients (mean age: 37,9 years) for whom all possible sites for execution of any other procedure had been exhausted, underwent latero-lateral AVF close to the adductor channel between the FA and the SFV. The FSV was released and sectioned 2 cm from its confluence with the deep femoral vein and transposed in the subcutaneous tissue with extensions using saphenous vein or prosthetic material (PTFE) when needed. Follow -up included patency, flow evaluation and complications. Results: Postoperative follow-up ranged from 3 to 96 months, with a mean of 38 months. The AVFs presented a flow of more than 350 ml/min and the AVFs remained patent for a mean period of 38 months. There were three failures of the procedures at 3, 5 and 7 months during postoperative follow-up due to graft infection and thrombosis (a case), anaphylactic shock and thrombosis (a case) and calf pain during dialysis (a case). Two patients developed slight inferior limb edema. Conclusion: The new surgical approach for access for hemodialysis represents a feasible procedure, with acceptable patency rates in exceptional cases where no other access option is available.

【 授权许可】

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