Transposition of the vena saphena magna in patients with exhausted vascular access possibilities on the upper limbs

Capa

Citar

Texto integral

Acesso aberto Acesso aberto
Acesso é fechado Acesso está concedido
Acesso é fechado Acesso é pago ou somente para assinantes

Resumo

Vascular access to the forearm in patients undergoing systemic hemodialysis (HD) is one of the key conditions for adequate HD. In situations where it is impossible to create vascular access in the upper limbs and there is total stenosis of the central veins, it is necessary to consider alternative vascular access routes. Formation of femoral arteriovenous fistula (AVF) is one of the possible places for creating such access. The article describes a rather rare type of vascular access, namely, transposition of the vena saphena magna in the form of a linear AVF with anastomosis of the femoral artery in the lower third. The course of the operation is described.

Texto integral

Acesso é fechado

Sobre autores

Andrey Yankovoy

Moscow Regional Research Clinical Institute named after M.F. Vladimirsky

Autor responsável pela correspondência
Email: 48yankovoy@mail.ru

Dr.Sci. (Med.), Senior Researcher, Kidney Transplantation Department

Rússia, Moscow

Bibliografia

  1. NKF, DOQI. Clinical practice guidelines and clinical practice recommendations for 2006 updates: hemodialysis adequacy, peritoneal dialysis adequacy and vascular access. Am. J. Kidney Dis. 2006;48(Suppl. 1):S1e322.
  2. Kendall T.W., Cull D.L., Carsten C.G. et al. The role of the prosthetic axilloaxillary loop access as a tertiary arteriovenous access procedure. J. Vasc. Surg. 2008;48:389–93. doi: 10.1016/j.jvs.2008.03.030.
  3. Parekh V.B., Niyyar V.D., Vachharajani T.J. Lower Extremity Permanent Dialysis Vascular Access. Clin. J. Am. Soc. Nephrol. 2016;11:1693. doi: 10.2215/CJN.01780216.
  4. Antoniou G.A., Lazarides M.K., Georgiadis G.S., et al. Lower-extremity arteriovenous access for haemodialysis: a systematic review. Eur. J. Vasc. Endovasc. Surg. 2009;38:365–72. http://dx.doi.org/10.1016/ j.ejvs.2009.06.003.
  5. Jackson M.R. The superficial femoral-popliteal vein transposition fistula: description of a new vascular access procedure. J. Am. Coll. Surg. 2000;191:581–4. doi: 10.1016/s1072-7515(00)00707-9.
  6. Huber T.S., Ozaki C.K., Flynn T.C., et al. Use of superficial femoral vein for hemodialysis arteriovenous access. J. Vasc. Surg. 2000;31:1038–41. doi: 10.1067/mva.2000.104587.
  7. Gradman W.S., Cohen W., Haji-Aghaii M. Arteriovenous fistula construction in the thigh with transposed superficial femoral vein: our initial experience. J. Vasc. Surg. 2001;33:968–75. http://dx.doi.org/10.1067/mva.2001.115000.
  8. Bourquelot P., Rawa M., Van Laere O., Franco G. Long-term results of femoral vein transposition for autogenous arteriovenous hemodialysis access. J. Vasc. Surg. 2012;56:440–5. doi: 10.1016/j.jvs.2012.01.068.
  9. Miller C.D., Robbin M.L., Barker J., Allon M. Comparison of arteriovenous grafts in the thigh and upper extremities in hemodialysis patients. J. Am. Soc. Nephrol 2003;14:2942–7. doi: 10.1097/01.asn.0000090746.88608.94.
  10. Ram S.J., Sachdeva B.A., Bharat A., et al. Thigh grafts contribute significantly to patients’ time on dialysis. Clin. J. Am. Soc. Nephrol. 2010;5:1229–34. doi: 10.2215/CJN.08561109.
  11. Aitken E., Jackson A.J., Kasthuri R., et al. Bilateral central vein stenosis: options for dialysis access and renal replacement therapy when all upper extremity access possibilities have been lost. J. Vasc. Access. 2014;15:466–73. doi: 10.5301/jva.5000268.
  12. Hazinedaroglu S.M., Tuzuner A., Ayli D., et al. Femoral vein transposition versus femoral loop grafts for hemodialysis: a prospective evaluation. Transplant. Proc. 2004;36:65–7. doi: 10.1016/j.transproceed.2003.11.031.
  13. Murad M.H., Elamin M.B., Sidawy A.N., et al. Autogenous versus prosthetic vascular access for hemodialysis: a systematic review and meta-analysis. J. Vasc. Surg. 2008;48(Suppl. 5): S34–47. doi: 10.1016/j.jvs.2008.08.044.
  14. Huber T.S., Carter J.W., Carter R.L., Seeger J.M. Patency of autogenous and polytetrafluoroethylene upper extremity arteriovenous hemodialysis accesses: a systematic review. J. Vasc. Surg. 2003;38(5):1005e11. Doi: 10.1016/ s0741-5214(03)00426-9.
  15. Georgakarakos E., Georgiadis G.S., Schoretsanitis N.G., et al. Composite PTFE-transposed superficial femoral vein for lower limb arteriovenous access. J. Vasc. Access. 2011;12:253–7. doi: 10.5301/JVA.2011.6387.
  16. Farber A., Woo K. Transposed arteriovenous fistulae: do the results justify the effort? Semin. Vasc. Surg. 2007;20:148–57. Doi: 10.1053/ j.semvascsurg.2007.07.008
  17. White J.G., Kim A., Josephs L.G., Menzoian J.O. The hemodynamics of steal syndrome and its treatment. Ann. Vasc. Surg. 1999;13:308–12. doi: 10.1007/s100169900263.
  18. Georgakarakos E.I., Georgiadis G.S., et al. Composite PTFE-transposed superficial femoral vein for lower limb arteriovenous access. Vasc. Access. 2011;12(3):253–7. doi: 10.5301/JVA.2011.6387.
  19. Korzets A., Ori Y., Baytner S., et al. The femoral artery-femoral vein polytetrafluoroethylene graft: a 14-year retrospective study. Nephrol. Dial. Transplant. 1998;13(5):1215e20. doi: 10.1093/ndt/13.5.1215.
  20. Miller C.D., Robbin M.L., Barker J., Allon M. Comparison of arteriovenous grafts in the thigh and upper extremities in hemodialysis patients. J. Am. Soc. Nephrol. 2003;14(11):2942e7. doi: 10.1097/01.asn.0000090746.88608.94.
  21. Khadra M.H., Dwyer A.J., Thompson J.F. Advantages of polytetrafluoroethylene arteriovenous loops in the thigh for hemodialysis access. Am. J. Surg. 1997;173(4):280e3. doi: 10.1016/S0002-9610(96)00405-9.

Arquivos suplementares

Arquivos suplementares
Ação
1. JATS XML
Baixar
2. Fig. 1. Stage of the operation. An incision is made along the right VSM Isolation of the femoral vein and sartorius muscle, under the muscle is the femoral vein. The sartorius muscle is indicated by the white arrow, the VSM is indicated by the black arrow.

Baixar (117KB)
Metadados
3. Fig. 2. Isolation of the femoral vein and femoral artery The light grey arrow highlights the VSM, the black arrow highlights the femoral artery, and the transparent arrow highlights the sartorius muscle.

Baixar (137KB)
Metadados
4. Fig. 3. Threading the VSM in a subcutaneous tunnel The transparent arrow indicates the VSM in the subcutaneous tunnel, the thin arrow indicates an additional incision on the skin.

Baixar (81KB)
Metadados
5. Fig. 4. The VSM is threaded in a subcutaneous tunnel and is brought to the femoral artery, which is located behind the sartorius muscle White arrow - femoral vein, light grey arrow - sartorius muscle.

Baixar (97KB)
Metadados
6. Fig. 5. Formation of AV anastomosis Anastomosis end of VSM to side of femoral artery. Black arrow - sartorius muscle, light grey arrow - femoral artery, transparent arrow - VSM, blue arrow - AV anastomosis site.

Baixar (156KB)
Metadados
7. Fig. 6. Scheme of the operation of transposition of the VSM for the formation of an AV anastomosis from the end of the vein to the side of the femoral artery in its lower third. Adapted from [7].

Baixar (29KB)
Metadados