scholarly journals Vascular Access in the Lower Limb

2016 ◽  
Vol 64 (5) ◽  
pp. 1538
Author(s):  
Cynthia Bhola ◽  
Denise Kim ◽  
Naomi Eisenberg ◽  
George Oreopoulos ◽  
Charmaine Lok ◽  
...  
Keyword(s):  
Vascular Access ◽  
Lower Limb

The transposed femoral vein arteriovenous fistula for hemodialysis

2018 ◽  
Vol 20 (2) ◽  
pp. 169-174
Author(s):  
Martin Söderman ◽  
Jes S Lindholt ◽  
Lene L Clausen
Keyword(s):  
Body Mass Index ◽  
Confidence Interval ◽  
Vascular Access ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Lower Limb ◽  
Femoral Vein ◽  
Wound Dehiscence ◽  
Feasible Method ◽  
Study Population

Introduction: The prevalence and incidence of patients in need of hemodialysis worldwide are increasing. The population in need of hemodialysis is becoming older and vascular comorbidities are more frequent than decades ago. Consequently, the prevalence of patients with exhausted possibilities of upper limb vascular accesses increases. In contrast to other lower limb vascular accesses, a fistula by transposing the femoral vein to the superficial femoral artery promises better patency rates in preliminary series. Methods: The first seven cases performed between October 2015 and March 2017 at the only center in Denmark performing this procedure were reviewed regarding demographics, comorbidities, complications, and patency. Results: The study population consisted of five males and two females, with a mean age of 61.6 ± 9.9 years, mean body mass index 24.9 ± 2.6, with various causes of uremia. Five patients (71.4%) experienced at least one complication, such as wound dehiscence, lymphocele, infection, hematoma, or steal. First cannulation of the transposing the femoral vein to the superficial femoral artery was conducted after 12.2 ± 4.3 weeks. Postoperatively, the patients have been followed 16.4 ± 9.6 months in the dialysis center. All but one is still using their transposing the femoral vein to the superficial femoral artery for dialysis, but three of these needed revision to maintain patency giving a primary and primary-assisted patency of 42.9 (95% confidence interval: 15.8–75.0) and 85.7 (95% confidence interval: 48.7–97.4), respectively. Conclusion: Although postoperative complications and need for revision to maintain patency persists, our experience suggests that this is a feasible method when it is no longer possible to create an upper extremity vascular access. A learning curve for the entire vascular access team must be expected.

Lower limb gigantism, lymphedema, and painful varicosities following a thigh vascular access graft

2014 ◽  
Vol 18 (3) ◽  
pp. 705-708 ◽  
Author(s):  
Michael Thompson ◽  
Umasankar Mathuram Thiyagarajan ◽  
Jacob A. Akoh
Keyword(s):  
Vascular Access ◽  
Lower Limb ◽  
Access Graft

Simultaneous Iliac Vein Bovine Pericardial Patch Venoplasty and Creation of PTFE Lower Limb Arteriovenous Fistula Graft for Rescue Vascular Access

2016 ◽  
Vol 36 ◽  
pp. 292.e9-292.e11 ◽  
Author(s):  
Lewis Meecham ◽  
Owain Fisher ◽  
George Kirby ◽  
Richard Evans ◽  
Pauline Buxton ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Lower Limb ◽  
Iliac Vein ◽  
Pericardial Patch ◽  
Bovine Pericardial Patch

Vascular assessment

2019 ◽  
pp. 161-168
Author(s):  
Colin Bigham
Keyword(s):  
Venous Thrombosis ◽  
Vascular Access ◽  
Lower Limb ◽  
Ultrasound Guided ◽  
Ultrasound Technique ◽  
Vascular Assessment ◽  
Arteries And Veins

Ultrasound-guided vascular access requires knowledge of the anatomy and the ultrasound appearances of normal and abnormal vessels in all regions where vascular access may be undertaken. This chapter describes the optimal ultrasound technique for imaging vessels, how to differentiate arteries and veins, and the normal appearances of the jugular, axillary, femoral, and upper and lower limb vessels. The technique for undertaking a lower limb scan to assess for venous thrombosis is outlined.

Different surgical techniques for lower limb permanent vascular access for hemodialysis

2018 ◽  
Vol 37 (4) ◽  
pp. 556
Author(s):  
MahmoudS Eldesouky ◽  
HeshamA Greda ◽  
OsmanAboelcibaa Osman ◽  
HebaE Kasem
Keyword(s):  
Vascular Access ◽  
Lower Limb ◽  
Surgical Techniques

Straight configuration saphenous vein transposition to popliteal artery for vascular access

2017 ◽  
Vol 18 (2) ◽  
pp. e15-e17 ◽  
Author(s):  
Gentian Caco ◽  
Dhurata Golemi ◽  
Eriola Likaj
Keyword(s):  
Upper Extremity ◽  
Vascular Access ◽  
Saphenous Vein ◽  
Popliteal Artery ◽  
Lower Limb ◽  
Vascular Graft ◽  
Arteriovenous Graft ◽  
Early Complications ◽  
Peripheral Artery

Introduction The saphenous vein is commonly used as a vascular graft in peripheral artery surgery but rarely used for vascular access. The literature on straight configuration saphenous vein transposition to the popliteal artery is scarce. Here we present two cases of straight configuration saphenous vein transposition to the popliteal artery for vascular access, the surgical technique and respective follow-up. Case report Two young men, aged 29 and 36 years, were chosen for lower-limb vascular access for hemodialysis. The first patient was paraplegic since birth. He used his arms to move so upper extremity vascular access was avoided. The second patient presented with an infected upper extremity arteriovenous graft (AVG) and after multiple closed AVFs he had no more available arm veins. Both patients received autologous lower extremity straight configuration saphenous vein transpositions to the popliteal artery under spinal anesthesia in May and October 2012, respectively. Cannulation of the fistula was allowed after one month. There were no early complications. Slight swelling on the leg appeared in one of the patients. Both fistulas were still functional after 36 and 32 months, respectively. Conclusions The straight configuration saphenous vein transposition to popliteal artery is simple to perform, offers a long and straight segment for cannulation and may be a suitable autologous vascular access in selected patients.

The chronically ischemic lower limb

JAMA ◽  
1966 ◽  
Vol 197 (11) ◽  
pp. 915-916
Author(s):  
I. J. Schatz
Keyword(s):  
Lower Limb
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