Algorithmic Salvage Techniques in Non-Maturing Radiocephalic Arteriovenous Fistulae with Their Long-Term Patency

Kordzadeh, Ali and Panayiotopoulos, Yiannis P. (2017) Algorithmic Salvage Techniques in Non-Maturing Radiocephalic Arteriovenous Fistulae with Their Long-Term Patency. Journal of Vascular Access, 18 (5). pp. 443-449. ISSN 1724-6032

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Official URL: https://doi.org/10.5301/jva.5000745

Abstract

Introduction: The aim of this study is to examine the role of five different operative salvage techniques with their long-term primary patency (PP) in an algorithmic manner in gaining primary functional maturation (FM) in radio cephalic arteriovenous fistulae (RCAVF) formation following their impairment. Methods: A prospective consecutive data collection on 195 patients undergoing only autogenous RCAVF formation from July 2013 to December 2015 was conducted. Each non-maturing fistula was then exposed to a salvage technique by an algorithmic methodology and their FM and PP was prospectively recorded. Results: Forty-two patients were exposed to five different salvages techniques, with a median age of 67 years (IQR, 27-90), cephalic vein diameter of 2 mm (IQR, 1.5-4 mm) and radial artery diameter of 1.8 mm (IQR, 1.2-2.1 mm), demonstrated 63.1% FM and cumulative primary patency of 15.2 months (95% CI, 12.5-17.9) over a 21-month follow-up period. Conclusions: Operative salvage techniques play an important role in achieving assisted functional maturation and long-term patency in RCAVF as an alternative and/or in conjunction with other minimally invasive procedures. These procedures can maximize access outcome, minimize bridging procedures, decrease complications and optimize patient anatomical resources for longer access provisions in an era of aging population.

Item Type: Journal Article
Keywords: Dorsal vein mobilization, Loop cephalic vein fistulae, Radiocephalic arteriovenous fistulae, Salvage techniques, Vein interposition, Vein patch plasty
Faculty: ARCHIVED Faculty of Medical Science (until September 2018)
Depositing User: Lisa Blanshard
Date Deposited: 18 Oct 2018 15:38
Last Modified: 14 Nov 2019 15:59
URI: http://arro.anglia.ac.uk/id/eprint/703703

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