Repair of Radial Artery with Autogenous Cephalic Vein Graft Interposition After Closure of Arteriovenous Fistula in a Young Renal Transplantation Patient

2013 ◽  
Vol 22 (2) ◽  
pp. 252-253
Author(s):  
Arda ÖZYÜKSEL ◽  
Sinan Sabit KOCABEYOĞLU ◽  
Erdem ÇETİN ◽  
Ertekin Utku ÜNAL
Keyword(s):  
Renal Transplantation ◽  
Arteriovenous Fistula ◽  
Radial Artery ◽  
Vein Graft ◽  
Cephalic Vein ◽  
Graft Interposition ◽  
Transplantation Patient

Venous distensibility is more important than venous diameter in primary survival of autogenous radiocephalic arteriovenous fistulas

2020 ◽  
Vol 21 (6) ◽  
pp. 963-968
Author(s):  
Guocun Hou ◽  
Yi Hou ◽  
Xiuli Sun ◽  
Na Yin ◽  
Guozhen Feng ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Confidence Interval ◽  
Arteriovenous Fistula ◽  
Radial Artery ◽  
Odds Ratio ◽  
Diabetic Kidney Disease ◽  
Peak Systolic Velocity ◽  
Cephalic Vein ◽  
Venous Distensibility ◽  
Vein Diameter

Background: Many studies suggested that the optimal cephalic vein diameter for wrist radio-cephalic arteriovenous fistula construction should be at least 2 mm to predict successful maturation and primary patency. However, our experience has shown that many patients with smaller cephalic vein diameter (≤2 mm) in the neutral state (without a tourniquet) also have good clinical outcomes. The aim of this study was to identify predictors that affect primary survival of new wrist radio-cephalic arteriovenous fistula in patients with cephalic vein diameter ≤2 mm. Methods: We performed a retrospective review of 50 patients with preoperative cephalic vein diameters ≤2 mm in the neutral state who underwent wrist radio-cephalic arteriovenous fistula construction between September 2016 and October 2019. Internal diameters of the cephalic vein and radial artery, venous distensibility, peak systolic velocity, and resistance index of the radial artery were determined by ultrasound examination before wrist radio-cephalic arteriovenous fistula placement. Patients were divided into two groups: failure and survival. Results: The radio-cephalic arteriovenous fistula survival rate was 68% from the time of radio-cephalic arteriovenous fistula creation until the end of the study. Univariate analysis showed that larger venous distensibility (p < 0.001), non-diabetic kidney disease (p = 0.009), and slower peak systolic velocity of the radial artery (p = 0.033) were predictive factors for primary radio-cephalic arteriovenous fistula survival. Multivariate regression analysis revealed good venous distensibility (odds ratio = 9.637, 95% confidence interval = 1.893–49.050, p = 0.006) and non-diabetic kidney disease (odds ratio = 0.148, 95% confidence interval = 0.033–0.660, p = 0.012) to be independent predictors for primary radio-cephalic arteriovenous fistula survival. Receiver operating characteristic analysis showed that venous distensibility >0.52 mm (sensitivity: 70.6%, specificity: 68.8%) was the best cut-off value to predict primary radio-cephalic arteriovenous fistula survival. Conclusion: When cephalic veins with diameter ≤2 mm are found, venous distensibility should be used to aid in the surgery decision-making process. The outcome of wrist radio-cephalic arteriovenous fistula survival would be significantly improved through the use of cephalic vein with venous distensibility >0.52 mm.

scholarly journals ADEFOVIR DIPIVOXIL IN COMBINATION WITH LAMIVUDIN IN RENAL TRANSPLANTATION PATIENT WITH YMDD MUTAION.

2008 ◽  
Vol 86 (Supplement) ◽  
pp. 683
Author(s):  
Y K. Son ◽  
Y H. Shin ◽  
J K. Kim ◽  
S S. Lee ◽  
K Hur
Keyword(s):  
Renal Transplantation ◽  
Adefovir Dipivoxil ◽  
Transplantation Patient

Does blood flow restriction training increase the diameter of forearm vessels in chronic kidney disease patients? A randomized clinical trial

2018 ◽  
Vol 19 (6) ◽  
pp. 626-633 ◽  
Author(s):  
Jefferson BN Barbosa ◽  
Tuíra O Maia ◽  
Priscila S Alves ◽  
Shirley D Bezerra ◽  
Elaine CSC Moura ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Chronic Kidney Disease ◽  
Blood Flow ◽  
Kidney Disease ◽  
Radial Artery ◽  
Handgrip Strength ◽  
Cephalic Vein ◽  
Blood Flow Restriction ◽  
Control Group ◽  
Flow Restriction

Introduction: Blood flow restriction training can be used as an alternative to conventional exercise in chronic kidney disease patients with indication of arteriovenous fistula. Objective: Evaluating the efficacy of blood flow restriction training in the diameter and distensibility change of the cephalic vein and the diameter and flow of the radial artery, muscle strength and forearm circumference in chronic kidney disease patients with arteriovenous fistula pre-creation. Methods: A blind randomized clinical trial consisting of 26 chronic kidney disease patients allocated into a blood flow restriction training group (blood flow restriction; n = 12) and a group without blood flow restriction training (control group; n = 14). Blood flow restriction was performed at 50% of systolic blood pressure and using 40% of handgrip strength as load for the isometric exercises in both groups. Results: An increase in the diameter of the cephalic vein in the 2 cm (p = 0.008) and 10 cm segments (p = 0.001) was observed in the control group. The diameter of the radial artery increased in all segments in the blood flow restriction group (2, 10 and 20 cm; p = 0.005, p = 0.021 and p = 0.018, respectively) and in the 10 and 20 cm segments (p = 0.017 and p = 0.026) in the control group. Handgrip strength only increased in the control group (p = 0.003). Conclusion: Physical training associated with blood flow restriction increased cephalic vein diameters in both groups and was effective in increasing the diameter of the radial artery; however, it did not demonstrate superiority over the exercise group protocol without blood flow restriction.

Forearm Cephalic Vein Graft for Short, “Middle”-Flow, Internal Maxillary Artery to Middle Cerebral Artery Bypass

2015 ◽  
Vol 12 (2) ◽  
pp. 99-105 ◽  
Author(s):  
Erez Nossek ◽  
Peter D Costantino ◽  
David J Chalif ◽  
Rafael A Ortiz ◽  
Amir R Dehdashti ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Saphenous Vein ◽  
Vein Graft ◽  
Artery Bypass ◽  
Cephalic Vein ◽  
Maxillary Artery ◽  
Internal Maxillary Artery ◽  
Vein Grafts ◽  
Graft Length

Abstract BACKGROUND The cervical carotid system has been used as a source of donor vessels for radial artery or saphenous vein grafts in cerebral bypass. Recently, internal maxillary artery to middle cerebral artery bypass has been described as an alternative, with reduction of graft length potentially correlating with improved patency. OBJECTIVE To describe our experience using the forearm cephalic vein grafts for short segment internal maxillary artery to middle cerebral artery bypasses. METHODS All vein grafts were harvested from the volar forearm between the proximal cubital fossa where the median cubital vein is confluent with the cephalic vein and the distal wrist. RESULTS Six patients were treated with internal maxillary artery to middle cerebral artery bypass. In 4, the cephalic vein was used. Postoperative angiography demonstrated good filling of the grafts with robust distal flow. There were no upper extremity vascular complications. All but 1 patient (mortality) tolerated the procedure well. The other 3 patients returned to their neurological baseline with no new neurological deficit during follow-up. CONCLUSION The internal maxillary artery to middle cerebral artery “middle” flow bypass allows for shorter graft length with both the proximal and distal anastomoses within the same microsurgical field. These unique variable flow grafts represent an ideal opportunity for use of the cephalic vein of the forearm, which is more easily harvested than the wider saphenous vein graft and which has good match size to the M1/M2 segments of the middle cerebral artery. The vessel wall is supple, which facilitates handling during anastomosis. There is lower morbidity potential than utilization of the radial artery. Going forward, the cephalic vein will be our preferred choice for external carotid-internal carotid transplanted conduit bypass.

One center’s experience with OKT3 in renal transplantation: patient and graft survival, complications, and cost analysis

2000 ◽  
Vol 32 (3) ◽  
pp. 572-573
Author(s):  
G Güz ◽  
R Emiroğlu ◽  
B Demirhan ◽  
F Köseoğlu ◽  
H Karakayalı ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Cost Analysis ◽  
Graft Survival ◽  
Transplantation Patient ◽  
Patient And Graft Survival
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