Superficialization of the radial artery – an alternative secondary vascular access
Superficialization of the radial artery – an alternative secondary vascular access
J Vasc Access 2012; 13(4): 504 - 507
DOI:10.5301/jva.5000079
Authors
Waclaw Weyde, Mariusz Kusztal, Tomasz Golebiowski, Krzysztof Letachowicz, Waldemar Letachowicz, Ewa Watorek, Katarzyna Madziarska, Magdalena Krajewska, Przemyslaw Szyber, Dariusz Janczak, Marian Klinger
Abstract
Purpose: The standard approach in patients with a clotted arteriovenous fistula (AVF) on the forearm is the creation of another vascular access on the arm using the patient’s own vessels or a prosthetic graft. Here we propose another option as secondary angioaccess for chronic hemodialysis (HD): superficialization of the radial artery. Methods: Indications for the procedure were 1) long-standing forearm AVF that has irreversibly clotted and/or central vein stenosis resistant to angioplasty; 2) patients who have no other prospect for forearm or even brachial AVF. The procedure was undertaken in 7 chronic HD patients dialyzed by forearm AVF for 27±26 months. Results: In one case the superficialization was abandoned intra-operatively due to small diameter of the artery (<4 mm). Five of 6 elevated arteries were patent and the follow-up period ranges from 11 to 15 (median 12) months. In 1 male patient with prothrombin G20210A mutation the artery clotted after 13 months of usage. Conclusions: Superficialized radial artery was successfully used for hemodialysis over one year. The only prerequisite for safe repeated puncture is a patent and enlarged radial artery. Due to avoidance of arteriovenous shunt this access type may be particularly suitable for patients with cardiac failure.
Article History
- • Accepted on 14/04/2012
- • Available online on 28/05/2012
- • Published in print on 16/01/2013
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Authors
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Weyde, Waclaw [PubMed] [Google Scholar]
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw - Poland
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Kusztal, Mariusz [PubMed] [Google Scholar]
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw - Poland
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Golebiowski, Tomasz [PubMed] [Google Scholar]
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw - Poland
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Letachowicz, Krzysztof [PubMed] [Google Scholar]
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw - Poland
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Letachowicz, Waldemar [PubMed] [Google Scholar]
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw - Poland
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Watorek, Ewa [PubMed] [Google Scholar]
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw - Poland
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Madziarska, Katarzyna [PubMed] [Google Scholar]
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw - Poland
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Krajewska, Magdalena [PubMed] [Google Scholar]
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw - Poland
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Szyber, Przemyslaw [PubMed] [Google Scholar]
Department of Vascular, General and Transplant Surgery, Wroclaw Medical University, Wroclaw - Poland
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Janczak, Dariusz [PubMed] [Google Scholar]
Department of Surgery, 4th Military Clinical Hospital in Wroclaw, Wroclaw - Poland
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Klinger, Marian [PubMed] [Google Scholar]
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw - Poland