Major complications of angioaccess surgery.
Angioaccess procedures at one institution over a 4-year period were retrospectively reviewed to ascertain the frequency of major limb- or life-threatening complications. A total of 435 angioaccess procedures were performed, including 81 Cimino-Brescia fistulas, 166 polytetrafluoroethylene grafts, and 111 thrombectomy/revisions. There were 77 operations for major complications in 53 patients. In addition, five patients required major vascular repair or emergency thoracotomy for complications of central hemodialysis line placement. A significant portion (18% of this series) of the total angioaccess caseload of a vascular surgeon will be utilized in the repair of major complications. The in-hospital (6 patients, or 11%) and long-term (12 patients, or 23%) mortality rates are significant. Although most complications can be repaired without limb loss and with shunt salvage, a small percentage (in our study three patients, or 4%) will have debilitating long-term symptoms.
Ballard
J L
JL
Department of Surgery, Maricopa Medical Center, Phoenix, Arizona 85010.
Bunt
T J
TJ
Malone
J M
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000209:etiology; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000401:mortality; D001424:Bacterial Infections / Q000209:etiology; D001807:Blood Vessel Prosthesis / Q000009:adverse effects / Q000401:mortality; D002405:Catheterization, Central Venous / Q000009:adverse effects; D003929:Diabetic Neuropathies / Q000209:etiology; D006801:Humans; D006973:Hypertension / Q000209:etiology; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000209:etiology; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods*; D012086:Reoperation; D012189:Retrospective Studies; D013349:Subclavian Steal Syndrome / Q000209:etiology; D013350:Subclavian Vein; D013927:Thrombosis / Q000209:etiology