A novel technique of reimplantation of a radial artery that makes a hairpin turn to reduce the excessive vascular access flow in a dialysis patient.

The Journal of Vascular Access
Sotaro KatsuiToshifumi Kudo

Abstract

We report a new technique called "reimplantation of an artery with a hairpin turn (RAHT)" to reduce excessive vascular access flow. A 73-year-old woman on dialysis consulted us for vascular surgery because of an increased cardiac preload. Chest radiography and echocardiography revealed an excessive shunt flow in the brachial artery (flow rate, 2336 mL/min). Vascular echo-Doppler of the left upper limb showed that the radial artery made a hairpin turn at the arteriovenous fistula (diameter, 9 mm). Diameters of the radial artery proximal and distal to the arteriovenous fistula were 5.4 and 3.7 mm, respectively. We ligated and divided the juxta-anastomosis proximal radial artery and subsequently created an end-to-side anastomosis between the proximal radial artery and the distal radial artery. The anastomosis ostium in the distal radial artery (the recipient) was formed with a 4-mm longitudinal and gently curved incision. We performed RAHT so that the small anastomosis between both arteries and the small diameter of the distal radial artery juxta-anastomosis segment could reduce the vascular access flow. The flow rates in the brachial artery were 500 mL/min just after surgery and 560 mL/min at 2 months after surgery. Postoperative...Continue Reading

References

Apr 28, 2004·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Jennifer M MacRaeRobert M Lindsay
Jul 30, 2005·Annals of Vascular Surgery·David J MinionEric Endean
Apr 3, 2010·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·P BourquelotA Raynaud
May 1, 2018·The New England Journal of Medicine·Mario GaudinoUNKNOWN RADIAL Investigators
May 8, 2018·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·Jürg SchmidliRamon Roca-Tey
Aug 18, 2018·Annals of Vascular Diseases·Takehisa Nojima, Yasuki Motomiya

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Methods Mentioned

BETA
coronary artery bypass

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