Arteriovenous fistula combined with brachial artery superficialization is effective in patients with a high risk of maturation failure Masaaki Murakami,

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Presentation transcript:

Arteriovenous fistula combined with brachial artery superficialization is effective in patients with a high risk of maturation failure Masaaki Murakami, MD, Genichi Sakaguchi, MD, PhD, Noriko Mori, MD Journal of Vascular Surgery Volume 65, Issue 2, Pages 452-458 (February 2017) DOI: 10.1016/j.jvs.2016.08.083 Copyright © 2016 Society for Vascular Surgery Terms and Conditions

Fig 1 A representative case of arteriovenous fistula (AVF) combined with brachial artery superficialization. A, We created the AVF and superficialized brachial artery simultaneously because preoperative vascular mapping showed that the radial artery was <2 mm and the straight segment for cannulation was <10 cm. B, The diameter of the superficialized brachial artery was 4.8 mm and the depth was 2.4 mm. The superficialized brachial artery has adequate caliber for blood drawing. Cannulation of the superficialized brachial artery is relatively easy. C, Postoperative view at 1 year shows mild aneurysmal changes of the superficialized brachial artery. The superficialized brachial artery is used as a drawing route, and the AVF is used as a return route. Journal of Vascular Surgery 2017 65, 452-458DOI: (10.1016/j.jvs.2016.08.083) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

Fig 2 Operative techniques of arteriovenous fistula (AVF) with brachial artery superficialization. A, In patients with a high risk of maturation failure, radial-cephalic AVF and superficialization of the brachial artery were performed. B, The forearm cephalic vein and the radial artery were exposed. C, The radial artery and the forearm cephalic vein were anastomosed. D, The brachial artery was exposed and the subcutaneous tissue under the brachial artery was sutured. Then, superficialization was achieved. A skin flap was placed over the superficialized brachial artery. E, The arrows show cannulation sites. Journal of Vascular Surgery 2017 65, 452-458DOI: (10.1016/j.jvs.2016.08.083) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

Fig 3 Kaplan-Meier curves show the primary and secondary patency rates for arteriovenous fistula (AVF) combined with brachial artery superficialization. ∗Standard error was >10% for primary patency at 387 days. Journal of Vascular Surgery 2017 65, 452-458DOI: (10.1016/j.jvs.2016.08.083) Copyright © 2016 Society for Vascular Surgery Terms and Conditions