Autogenous arteriovenous elbow fistula for haemodialysis and upper extremity ischemia.
BACKGROUND
The autogenous brachiocephalic or brachiobasilic arteriovenous elbow fistula is not considered to be only the secondary haemodialysis access. In patients with an unsuitable forearm vessel bundle, it is indicated as primary access and it is the method preferred to the fistula creation using a vascular prosthesis. Its rather rare complication is the development of upper extremity ischemia.


OBJECTIVE
To summarise current knowledge of this fistula type and its associated complications


METHODS
Review of the literature.


RESULTS
The creation and maturation of the fistula and occurrence of the steal syndrome is influenced by a number of factors. The analysis and awareness of such factors will provide for creation of a suitable fistula as well as for timely complication diagnostics and treatment.


CONCLUSIONS
The autogenous elbow fistula utilising the brachial artery and the cephalic or basilic vein in the upper extremity represents a high-quality haemodialysis access. Its potential complication is the occurrence of the steal syndrome. Its occurrence and manifestations do not constitute indications for ligation of the access. The gathered information shows that a suitable surgical procedure can help meet the basic rule for haemodialysis access--resolving the ischemia and maintaining the access.
Bachleda
Petr
P
2nd Department of Surgery, University Hospital Olomouc, Czech Republic. petr.bachleda@fnol.cz
Utikal
Petr
P
Kojecky
Zdenek
Z
Drac
Petr
P
Köcher
Martin
M
Cerna
Marie
M
Zadrazil
Josef
J
D001166:Arteriovenous Shunt, Surgical / Q000379:methods*; D001916:Brachial Artery / Q000601:surgery; D004550:Elbow; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D006435:Renal Dialysis; D034941:Upper Extremity / Q000098:blood supply*; D014680:Veins / Q000637:transplantation