Tagliatelle technique for arteriovenous fistula creation using a great saphenous vein semipanel graft Faris Alomran, MD, Benoit Boura, MD, Alexandros.

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Presentation transcript:

Tagliatelle technique for arteriovenous fistula creation using a great saphenous vein semipanel graft Faris Alomran, MD, Benoit Boura, MD, Alexandros Mallios, MD, Romain De Blic, MD, Alessandro Costanzo, MD, Myriam Combes, MD Journal of Vascular Surgery Volume 58, Issue 6, Pages 1705-1708 (December 2013) DOI: 10.1016/j.jvs.2013.06.082 Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 1 a, Great saphenous vein (GSV) opened longitudinally up to 5 cm from saphenofemoral junction. b, Open valvulotomy using Pott's scissors. c, Folding of the GSV at its center, creating anterior and posterior vein panels. d, Suturing of the medial edges, followed by the lateral edges together. e, Subcutaneous tunnelization of reconstructed graft to maximize puncture length. f, Small side-to-end arteriovenous (AV) anastomosis performed. Journal of Vascular Surgery 2013 58, 1705-1708DOI: (10.1016/j.jvs.2013.06.082) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 2 a, The medial edge suture is complete as represented by the posterior aspect of the reconstructed vein panel in this image. The lateral edge suture can be seen to have started on the right side of the image. b, Testing of the reconstructed great saphenous vein (GSV) using gentle hydropressure through a small venotomy for the arteriovenous (AV) anastomoses. c, A maximum of 4-mm side-to-end arteriovenous (AV) anastomosis is performed. Journal of Vascular Surgery 2013 58, 1705-1708DOI: (10.1016/j.jvs.2013.06.082) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 3 Computed tomography angiography (CTA) reconstruction of the arteriovenous (AV) fistula showing subcutaneous puncture length of 13 cm (a) and harmonious vessel diameter between 7 and 8 mm thoughout (b). Journal of Vascular Surgery 2013 58, 1705-1708DOI: (10.1016/j.jvs.2013.06.082) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 4 Upper thigh of patient showing the lateral tunnelization of the arteriovenous (AV) fistula lateral to the surgically scarred area. A, Signifies the direction of the AV anastomosis; V, signifies the direction of the iliac vein. Journal of Vascular Surgery 2013 58, 1705-1708DOI: (10.1016/j.jvs.2013.06.082) Copyright © 2013 Society for Vascular Surgery Terms and Conditions