Venae comitantes fistulae: an option in patients with difficult hemodialysis access.
OBJECTIVE
To evaluate the outcome of use of venae comitantes vessels in the formation of arterio-venous fistulae as vascular access for hemodialysis, in patients with limited venous anatomy.


METHODS
Twenty patients who underwent arterio-venous anastomosis between brachial artery and venae comitantes were identified (2002 - 2005) and the notes reviewed.


RESULTS
There was early failure in two (10%) patients (immediate postoperative period) and a further four (20%) failed late (mean 26 weeks, range 7-60). One patient developed a steal syndrome with radial nerve dysfunction requiring ligation of the fistula. Six (30%) patients utilised their fistulae for dialysis successfully without additional surgery and a further 6(30%) required surgical intervention to exteriorise the fistulae by the use of interposition grafts to allow successful use.


CONCLUSIONS
Venae Comitantes arterial fistulae offer an option in patients with limited venous anatomy for standard reconstruction. If access surgery utilizes such veins second stage procedures are often required with overall 70% use.
Srinivasaiah
N
N
Renal Transplant Unit , Freeman Hospital, Newcastle upon Tyne, UK. simha_anu@yahoo.com
Yalamuri
R R
RR
Umez-Eronini
N O
NO
Rix
D
D
Talbot
D
D
D000328:Adult; D000368:Aged; D001166:Arteriovenous Shunt, Surgical; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome; D014463:Ultrasonography; D014654:Vascular Patency; D014680:Veins / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*