title: Radial artery approach to salvage nonmaturing radiocephalic arteriovenous fistulas.
abstract: OBJECTIVE
  To evaluate the usefulness of an approach through the radial artery distal to the arteriovenous anastomosis for salvaging nonmaturing radiocephalic arteriovenous fistulas.
  
  
  METHODS
  Procedures that fulfilled the following criteria were retrospectively reviewed: (1) autogenous radiocephalic fistulas, (2) fistulas less than 3 months old, (3) distal radial artery approach for salvage. From 2005 to 2011, a total of 51 patients fulfilling the above criteria were enrolled. Outcome variables were obtained from angiographic, clinical and hemodialysis records, including the success, complication, and primary and secondary patency rates.
  
  
  RESULTS
  The overall anatomical and clinical success rates for the distal radial artery approach were 96 and 94%, respectively. The average procedure time was 36 ± 19 min. Six patients (12%) experienced minor complications as a result of extravasations. No arterial complication or puncture site complication was noted. The postinterventional 6-month primary patency rate was 51%, and the 6-month secondary patency rate was 90%. When the patients were divided into a stenosed group (20 patients) and an occluded group (31 patients), there were no differences in the success rate, complication rate, or primary and secondary patency rates.
  
  
  CONCLUSIONS
  An approach through the radial artery distal to the arteriovenous anastomosis is an effective and safe alternative for the salvage of nonmaturing radiocephalic arteriovenous fistulas, even for occluded fistulas.
authors.affiliation: Department of Cardiology, National Taiwan University Hospital, Hsin-Chu Branch, No. 25, Lane 442, Sec.1, Jingguo Rd, Hsinchu City, Taiwan.
authors.forename: Mu-Yang
authors.initials: MY
authors.lastname: Hsieh
authors.forename: Lin
authors.initials: L
authors.lastname: Lin
authors.forename: Kuei-Chin
authors.initials: KC
authors.lastname: Tsai
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Wu
mesh_terms: D000368:Aged; D000792:Angiography / Q000379:methods; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging* / Q000628:therapy*; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects / Q000379:methods; D015331:Cohort Studies; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D017534:Radial Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D016879:Salvage Therapy / Q000379:methods*; D018709:Statistics, Nonparametric; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D062666:Vascular Access Devices / Q000009:adverse effects; D014654:Vascular Patency / Q000502:physiology