Saphenofemoral arteriovenous fistula as hemodialysis access

BMC Surgery

Research Article

João R Breda¹  Alexandre C Fioretti¹  João A Correa¹  Adilson C Pires¹  Yumiko R Yamazaki¹  Luiz Carlos M Vanderlei²  Fausto Miranda³  Eduardo Colombari⁴  Luiz Carlos de Abreu⁴  Hugo Macedo Junior⁴  Vitor E Valenti⁵ 

[1] Departamento de Cirugia da Faculdade de Medicina do ABC, Santo André, SP, Brazil;Departamento de Fisioterapia, Universidade Estadual Paulista (UNESP), Presidente Prudente, SP, Brazil;Disciplina de Cirurgia Cardiovascular, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil;Laboratório de Escrita Científica, Departamento de Morfologia e Fisiologia, Faculdade de Medicina do ABC, Santo André, SP, Brazil;Laboratório de Escrita Científica, Departamento de Morfologia e Fisiologia, Faculdade de Medicina do ABC, Santo André, SP, Brazil;Departamento de Medicina, Disciplina de Cardiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil;

关键词: Saphenous Vein;    Vascular Access;    Superficial Femoral Artery;    Inguinal Region;    Primary Patency;   

DOI  :  10.1186/1471-2482-10-28

 received in 2010-03-16, accepted in 2010-10-18,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundAn upper limb arteriovenous (AV) fistula is the access of choice for haemodialysis (HD). There have been few reports of saphenofemoral AV fistulas (SFAVF) over the last 10-20 years because of previous suggestions of poor patencies and needling difficulties. Here, we describe our clinical experience with SFAVF.MethodsSFAVFs were evaluated using the following variables: immediate results, early and late complications, intraoperative and postoperative complications (up to day 30), efficiency of the fistula after the onset of needling and complications associated to its use.ResultsFifty-six SFAVF fistulas were created in 48 patients. Eight patients had two fistulas: 8 patent (16%), 10 transplanted (20%), 12 deaths (24%), 1 low flow (2%) and 20 thrombosis (39%) (first two months of preparation). One patient had severe hypotension during surgery, which caused thrombosis of the fistula, which was successfully thrombectomised, four thrombosed fistulae were successfully thrombectomised and revised on the first postoperative day. After 59 months of follow-up, primary patency was 44%.ConclusionSFAVF is an adequate alternative for patients without the possibility for other access in the upper limbs, allowing efficient dialysis with good long-term patency with a low complication rate.

【 授权许可】

CC BY   
© Correa et al; licensee BioMed Central Ltd. 2010