scholarly journals AVA 3. Efficacy of Staged Brachial Artery-Basilic/Brachial Vein Elevation Arteriovenous Fistula (Axillary Vein Saved)

2018 ◽  
Vol 68 (5) ◽  
pp. e125
Author(s):  
Min-seob Kim ◽  
Sanghyun Ahn ◽  
Hyejin Mo ◽  
Ahram Han ◽  
Chanjoong Choi ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Brachial Artery ◽  
Axillary Vein ◽  
Brachial Vein

Brachio-brachial arteriovenous fistula combined with superficialization of the brachial artery using a short skin incision for hemodialysis

2020 ◽  
pp. 112972982094408
Author(s):  
Tsuyoshi Takashima ◽  
Yui Nakashima ◽  
Atsuhiko Suenaga ◽  
Yuki Yamashita ◽  
Yasunori Nonaka ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Brachial Artery ◽  
English Literature ◽  
Invasive Procedure ◽  
Skin Incision ◽  
Related Data ◽  
One Stage ◽  
Long Time ◽  
Brachial Vein

A brachio-brachial arteriovenous fistula with superficialization of the brachial vein and superficialization of the brachial artery are useful vascular access techniques for hemodialysis patients. However, both typically require a long skin incision from the antecubital fossa toward the axillary fossa. In addition, the brachio-brachial arteriovenous fistula in particular, which is created with not a one-stage but a two-stage procedure, requires a relatively long time of 2–3 months before it can be used for hemodialysis. Furthermore, superficialization of the brachial artery usually requires nonarterialized superficial veins for blood return. In cases where patients have no adequate superficial veins for creating an arteriovenous fistula, we have adopted a one-stage operative technique to create a brachio-brachial arteriovenous fistula with superficialization of not only the brachial vein but also the brachial artery using a short skin incision. This technique of a brachio-brachial arteriovenous fistula with superficialization of the brachial artery has several advantages over traditional approaches, including a minimally invasive procedure and early use for vascular access. To our knowledge, the presently described technique and the related data have not been previously reported in the English literature. We herein report the steps of this technique and the midterm follow-up outcomes.

Anatomical variations in upper arm vasculature pertinent to haemodialysis access creation: are surgeons aware sufficiently?

2020 ◽  
pp. 1-14
Author(s):  
Zia Ur Rehman ◽  
Zainab Majid ◽  
Laila Tul Qadar ◽  
Aamina Majid
Keyword(s):  
Arteriovenous Fistula ◽  
Brachial Artery ◽  
End Stage Renal Disease ◽  
Anatomical Variations ◽  
Chronic Hemodialysis ◽  
Basilic Vein ◽  
Increased Risk ◽  
Brachial Vein ◽  
Stage Renal Disease ◽  
End Stage

Abstract There exist wide anatomical variations of upper limb. Their implication is perhaps greatest when it comes to failure of arteriovenous fistula (AVF) for chronic hemodialysis. Among arteries of forearm, brachial artery is of note, whose high bifurcation is associated with increased risk of failure. The superficial and accessory variants also cause difficulty for the surgeon. The single unpaired brachial vein and stenosis of cephalic vein compound the difficulties associated with AVF among many others. A thorough understanding of surgeons regarding normal anatomy and diverse variants holds high importance in context of deciding an appropriate site for arteriovenous (AV) anastomosis. Negligence in creation of fistula not only pose a threat to patients of end stage renal disease (ERSD) but also contributes to numerous other complications involving nerves and drug administration. Keywords: Brachial artery; basilic vein; arteriovenous fistula; vascular variations. Continuous....

scholarly journals An arteriovenous fistula utilizing brachial artery and brachial vein with superficial repositioning

2003 ◽  
Vol 36 (5) ◽  
pp. 311-315
Author(s):  
Tomoteru Kishimoto ◽  
Masato Tamura ◽  
Tomoyuki Shiotsu ◽  
Shoichiro Nakamura
Keyword(s):  
Arteriovenous Fistula ◽  
Brachial Artery ◽  
Brachial Vein

Skin perfusion pressure for predicting access-related hand ischemia following arteriovenous fistula surgery based on the brachial artery

2021 ◽  
pp. 112972982199398
Author(s):  
Miju Bae ◽  
Sung Woon Chung ◽  
Chung Won Lee ◽  
Up Huh ◽  
Moran Jin ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Sensitivity And Specificity ◽  
Brachial Artery ◽  
Perfusion Pressure ◽  
Characteristic Curve ◽  
Major Complication ◽  
Clinical Predictors ◽  
Skin Perfusion ◽  
Hand Ischemia ◽  
Skin Perfusion Pressure

Background: Access-related hand ischemia (ARHI) is a major complication of arteriovenous fistula (AVF). This study aimed to assess the predictive efficacy of skin perfusion pressure (SPP) measurement for ARHI by examining the relationship between SPP and ARHI development and progression after AVF surgery. Methods: Twenty-five patients (16 men and 9 women) who underwent AVF surgery based on the brachial artery between January 2018 and December 2018 were included. The pre- and postoperative SPP values were measured on the day of surgery. ARHI occurrence and severity were measured within 3 days and at 6 months after surgery. Receiver operating characteristic curve analysis was used to evaluate the prediction model of ARHI, and the cutoff points for the calculated coefficients were determined. Results: There was a significant correlation between the occurrence of immediate ARHI and the SPP gradient ( p = 0.024). An SPP gradient value >50 mmHg had sensitivity and specificity values of 53.85% and 91.67%, respectively, in predicting the occurrence of immediate ARHI. A postoperative SPP <48 mmHg was significantly correlated with the occurrence of 6-month ARHI ( p = 0.005), with sensitivity and specificity values of 71.43% and 83.33%, respectively. Conclusion: The SPP gradient and postoperative SPP values may be effective clinical predictors of ARHI occurring immediately and 6 months after surgery, respectively, with high specificity. These findings could allow clinicians to diagnose and begin early interventions to help prevent ischemic tissue damage in hemodialysis patients following AVF surgery.

Atypical presentation of fistula dysfunction due to brachial arterial embolization mimicking stroke

2022 ◽  
pp. 112972982110676
Author(s):  
Rita Vicente ◽  
Laura Rodriguez ◽  
Joaquim Vallespín ◽  
Carolina Rubiella ◽  
Jose Ibeas
Keyword(s):  
Arteriovenous Fistula ◽  
Doppler Ultrasound ◽  
Vascular Access ◽  
Brachial Artery ◽  
Arterial Embolization ◽  
Limb Ischemia ◽  
Artery Occlusion ◽  
Bedside Ultrasound ◽  
Computed Tomographic ◽  
Ultrasound Evaluation

Vascular access thrombosis is an important complication with great impact on access patency and, consequently, on a patient’s quality of life and survival. We report the case of a 73-year-old woman with chronic kidney disease on hemodialysis with a radiocephalic arteriovenous fistula on the right arm that was brought to the emergency department with decreased strength in her right arm, ipsilateral hypoesthesia and facial hemi-hypoesthesia. The patient was given a brain computed tomographic scan that did not confirm suspicion of stroke. On re-examination, the patient had new-onset pain at arteriovenous fistula level, and her right arm was cold and pale. The nephrology department was called for arteriovenous fistula evaluation. On physical examination, her forearm fistula had a decreased thrill and arm elevation exacerbated its paleness. A bedside ultrasound was performed for arteriovenous fistula assessment. Doppler ultrasound revealed: partial thrombosis at brachial bifurcation, a flow of 80–105 mL/min at brachial artery level and a radial artery with a damped waveform. Anastomosis and draining vein were permeable. In this case, the diagnosis of acute embolic brachial artery occlusion was made by a fast bedside ultrasound evaluation. The patient underwent thromboembolectomy with Fogarty technique, recovering fistula thrill, radial and cubital pulses. Thromboembolism of the fistula feeding artery is a rare cause of vascular access thrombosis and it is rarely mentioned in the literature. In this report, failure to recognize the upper limb ischemia would have led to delayed treatment, potentially resulting in the fistula’s complete thrombosis and further limb ischemia. We highlight the importance of a diagnosis method like Doppler ultrasound, which allows for rapid evaluation at the patient’s bedside.

Superficialization of Basilic Vein: Last Chance for a Native Arteriovenous Fistula in Hemodialysis Patients

2003 ◽  
Vol 4 (1) ◽  
pp. 21-24 ◽  
Author(s):  
M. Onaran ◽  
D. Erer ◽  
I. Şen ◽  
E.E. Elnur ◽  
E. Iriz ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Brachial Artery ◽  
Subcutaneous Tissue ◽  
Vascular Grafts ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Basilic Vein ◽  
Number Of Patients

Background Although the best type of vascular access for chronic hemodialysis patients is a native arteriovenous fistula, in an increasing number of patients all the superficial veins have been used and only the placement of vascular grafts or permanent catheters is left. Superficialization of the basilic vein is a possible alternative. Materials and Methods In 49 chronic hemodialysis patients who had no possibilities to have a native arteriovenous fistula created, we performed a basilic vein- brachial artery fistula in the arm. During the same operation the basilic vein was then superficialized for easier access for hemodialysis. Results Mean follow-up was 22.36±15.56 months. Forty-eight patients are still undergoing hemodialysis with their superficialized basilic vein native A-V fistula without any complications. Only one fistula was thrombosed just after the procedure because of poor vessel quality. Conclusion For hemodialysis patients who have no suitable superficial veins at the wrist or elbow, performing a basilic vein - brachial artery fistula and superficializing the vein to the subcutaneous tissue is an acceptable choice before deciding to use more complicated procedures like vascular grafts.

scholarly journals Brachial Vein Transposition Arteriovenous Fistula for Hemodialysis Access

2012 ◽  
Vol 23 (2) ◽  
pp. 59-64
Author(s):  
Harunobu Matsumoto ◽  
Eisuke Yamamoto ◽  
Chiaki Kamiya ◽  
Emi Miura ◽  
Tadashi Kitaoka ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Hemodialysis Access ◽  
Brachial Vein

scholarly journals Refractory axillary venous spasm during permanent pacemaker implantation

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Krishna Santosh Vemuri ◽  
Nitin Parashar ◽  
Dinakar Bootla ◽  
Pruthvi C. Revaiah ◽  
Kewal Kanabar ◽  
...  
Keyword(s):  
Pacemaker Implantation ◽  
Arterial System ◽  
Seldinger Technique ◽  
Anatomical Landmarks ◽  
Axillary Vein ◽  
Access Site ◽  
Intravenous Contrast ◽  
Device Implantation ◽  
Brachial Vein ◽  
The Right

Abstract Background Vascular spasm is well known to occur in the arterial system. Central venous spasm during pacemaker implantation is uncommon with only a few cases reported from time to time. Sometimes, the venous spasms may not respond to nitroglycerine injections which requires a change of access site and undue discomfort for the patient. Case presentation A 72-year-old female patient with no prior comorbidities presented to us with recurrent dizziness on exertion and at rest. The electrocardiogram showed complete heart block, likely to be of sclerodegenerative etiology as the patient did not have any ischemic symptoms, also the electrocardiogram and echocardiogram did not show any evidence of ischemia. As part of the hospital protocol, a venogram was performed by giving intravenous diluted contrast (iohexol) through the left brachial vein, which showed good-sized axillary and subclavian veins. We attempted to cannulate the left axillary vein with a 16G needle using Seldinger technique, but the axillary vein could not be cannulated despite multiple attempts. We gave incremental boluses of intravenous nitroglycerine, despite that the left axillary vein could not be cannulated. Repeat intravenous contrast injection showed severe spasm of axillary and subclavian veins. Finally, the axillary vein was cannulated from the right side using anatomical landmarks and a pacemaker was implanted. Conclusions Venous spasm during device implantation although uncommon, it should be anticipated in patients with difficult cannulation to prevent inadvertent complications like pneumothorax and arterial injuries. Mild venous spasm may relieve with time but severe venous spasm may require a change of access site

Catheter-related obstruction of the right brachiocephalic vein following hemodialysis in a patient with lupus nephritis

2020 ◽  
pp. 112972982092608
Author(s):  
Mitsutoshi Shindo ◽  
Kenichi Oguchi ◽  
Chihiro Kimikawa ◽  
Kiyonori Ito ◽  
Jyunki Morino ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Brachiocephalic Vein ◽  
Central Vein ◽  
Axillary Vein ◽  
Arteriovenous Graft ◽  
Complete Obstruction ◽  
Hemodialysis Catheter ◽  
The Right

Vascular access is necessary for hemodialysis, and in some cases where it is difficult to establish an arteriovenous fistula or arteriovenous graft, a permanent hemodialysis catheter may be used. However, serious catheter-related complications, such as central vein stenosis or thrombosis, can occur. We herein present a case of complete brachiocephalic vein obstruction in a patient with lupus nephritis receiving hemodialysis using a tunneled hemodialysis catheter. A 64-year-old patient underwent maintenance hemodialysis while taking an anticoagulant, with a tunneled hemodialysis catheter in the right internal jugular vein, because of arteriovenous fistula failure when hemodialysis was introduced. However, the catheter was removed because of a catheter-related bloodstream infection. Following the administration of antibiotics, an arteriovenous graft was implanted between the brachial artery and axillary vein in the right arm. Surprisingly, arteriovenous graft failure and complete obstruction of the right brachiocephalic vein were observed 3 days after arteriovenous graft creation. In conclusion, we report the case of tunneled hemodialysis catheter-related complete obstruction of the right brachiocephalic vein in a lupus nephritis patient undergoing hemodialysis. Clinicians should be aware of this potential complication when tunneled hemodialysis catheters are used and consider the next vascular access type before a tunneled hemodialysis catheter has been indwelled for the long term.

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