Long-segment plication technique for arteriovenous fistulae threatened by diffuse aneurysmal degeneration: short-term results

Annals of Vascular Surgery
Alexis PowellWesley Gabbard

Abstract

A substantial number of patients with autologous arteriovenous fistulas (AVFs) develop diffuse aneurysmal degeneration, which frequently interferes with successful access. These AVFs are often deemed unsalvageable. We hypothesize that long-segment plication in these patients can be performed safely with acceptable short-term AVF salvage rates. We reviewed a prospectively maintained database to identify all patients with extensive AVF aneurysmal disease operated on for this problem. Thirty-five patients, 25 (71%) male and 10 (29%) female were operated on between July 2012 and January 2014. AVFs included 23 (66%) brachiocephalic, 5 (14%) radiocephalic, and 7 brachiobasilic (20%) fistulae (one first stage only but in use). The cohort had one or a combination of local pain, arm edema, cannulation issue, recurrent thrombosis, dysfunctional during dialysis, or extreme tortuousity. Time range for AVF creation to consultation ranged from 3 months to 11 years. All underwent long-segment plication over a 20-Fr Bougie with or without segmental vein resection; 3 underwent concomitant first rib resection for costoclavicular stenosis; 21 patients had tunneled catheter placement for use while healing, whereas 13 were allowed segmental use of ...Continue Reading

References

Jun 27, 2006·Transplantation Proceedings·H SalahiS-A Malek-Hosseini
Feb 6, 2007·Vascular and Endovascular Surgery·George E PierceJames R Fenton

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Citations

Nov 4, 2017·The Journal of Vascular Access·Nicholas InstonDomenico Valenti
Jun 2, 2020·Annals of Vascular Surgery·Danielle T FontenotKarl A Illig

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