[High-flux arteriovenous fistula at the anatomic snuffbox].
Based on 25 years of haemodialysis experience, the authors confirm the importance of arteriovenous fistula at the anatomic snuff-box by L-L anastomosis with vessel end-tie, and assert that, even using small vessels, through simple devices, it is possible to achieve high-flux vascular access, that can be employed also for high-efficiency treatments (HF, HDF). The advantages and the troubles of this vascular access are considered and also the reasons that lead to dropping this arterio-venous fistula too. The authors describe the surgical technique and the devices of the procedure, based on their case-reports of 131 arteriovenous fistulas at the anatomic snuff-box, immediately working in 95% of the cases and compatible with high-flux blood in 67% of cases. Fine adventitial bridle resection is very important, because this procedure allows us to rest the venous vessel wall on the top of the fistula; the ligature of all collateral vessels is very important too. The arteriovenous fistula at the anatomic snuff-box (L-L terminated, with anastomotic leak of 5 mm) is the most advisable vascular access for all the patients in whom we can plan the start of dialysis some months advance.
Boccardo
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UOA di Nefrologia e Dialisi, USL 16, Regione Piemonte, Ceva, Cuneo.
Ettari
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Donato
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De Prisco
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Maurino
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D
D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D001783:Blood Flow Velocity; D016121:Brachiocephalic Veins / Q000601:surgery*; D005069:Evaluation Studies as Topic; D006225:Hand / Q000098:blood supply; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D017534:Radial Artery / Q000601:surgery*; D006435:Renal Dialysis / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors
Fistola artero-venosa ad alta portata alla tabacchiera anatomica.