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

Vascular ◽  
2021 ◽  
pp. 170853812110451
Author(s):  
Brieuc Panhelleux ◽  
Joseph Shalhoub ◽  
Anne K Silverman ◽  
Alison H McGregor

Objectives Through-knee amputation is an umbrella term for several different surgical techniques, which may affect clinical and functional outcomes. This makes it hard to evaluate the benefits and need for a through-knee amputation approach. This article seeks to (1) determine the number of through-knee amputation performed compared with other major lower limb amputations in England over the past decade; (2) identify the theoretical concepts behind through-knee amputation surgical approaches and their potential effect on functional and clinical outcomes and (3) provide a platform for discussion and research on through-knee amputation and surgical outcomes. Methods National Health Service Hospital Episodes Statistics were used to obtain recent numbers of major lower limb amputations in England. EMBASE and MEDLINE were searched using a systematic approach with predefined criteria for relevant literature on through-knee amputation surgery. Results In the past decade, 4.6% of major lower limb amputations in England were through-knee amputations. Twenty-six articles presenting through-knee amputation surgical techniques met our criteria. These articles detailed three through-knee amputation surgical techniques: the classical approach, which keeps the femur intact and retains the patella; the Mazet technique, which shaves the femoral condyles into a box shape and the Gritti-Stokes technique, which divides the femur proximal to the level of the condyles and attaches the patella at the distal cut femur. Conclusions Through-knee amputation has persisted as a surgical approach over the past decade, with three core approaches identified. Studies reporting clinical, functional and biomechanical outcomes of through-knee amputation frequently fail to distinguish between the three distinct and differing approaches, making direct comparisons difficult. Future studies that compare through-knee amputation approaches to one another and to other amputation levels are needed.


1978 ◽  
Vol 13 (6) ◽  
pp. 724-729 ◽  
Author(s):  
Raphael H. Levey ◽  
Stephen Sallen ◽  
Howard Weinstein ◽  
Norman Jaffe

2018 ◽  
Vol 20 (2) ◽  
pp. 169-174
Author(s):  
Martin Söderman ◽  
Jes S Lindholt ◽  
Lene L Clausen

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.


2014 ◽  
Vol 18 (3) ◽  
pp. 705-708 ◽  
Author(s):  
Michael Thompson ◽  
Umasankar Mathuram Thiyagarajan ◽  
Jacob A. Akoh

2010 ◽  
Vol 51 (3) ◽  
pp. 786
Author(s):  
J.H.M. Tordoir ◽  
M.M. van Loon ◽  
N. Peppelenbosch ◽  
A.S. Bode ◽  
M. Poeze ◽  
...  

2016 ◽  
Vol 36 ◽  
pp. 292.e9-292.e11 ◽  
Author(s):  
Lewis Meecham ◽  
Owain Fisher ◽  
George Kirby ◽  
Richard Evans ◽  
Pauline Buxton ◽  
...  

2020 ◽  
Vol 27 (1) ◽  
pp. 26-30
Author(s):  
D. D. Bolotov

In the mid-end of the last century, unification was carried out to select the level of limb trimming, based on the principle of achieving the maximum possible functionality in the stump-prosthesis system. Over time, due to the development of surgical techniques and the level of prosthetic and orthopedic products, previously developed schemes for choosing the level of amputation have lost their relevance. However, the most typical complications and the associated decrease in prosthetics functionality continue to occur in the current time period. The article provides an analysis of the possible variants of complications in relation to the level of limb truncation, options for their prevention and elimination, and how the general assessment of the effect on the stat-dynamic function of the stump length at various levels is presented.


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