Background: This study compared clinical outcomes between the use of in situ and free internal thoracic artery grafts in patients with upper extremity arteriovenous fistula who underwent coronary artery bypass.
Methods: We reviewed 85 hemodialysis-dependent patients with upper extremity arteriovenous fistula who underwent coronary artery bypass with internal thoracic artery grafts. The patients were categorized into 2 groups; 48 (56%) with in situ graft ipsilateral to the arteriovenous fistula (group I) and 37 (44%) with free grafts anastomosed to the ascending aorta (group F). The follow-up period was 32.0 ± 38.1 months.
Results: The estimated overall survival rates at 3, 5, and 10 years were 89.5%, 81.6%, and 53%, respectively, for all discharged patients. There was no significant difference in in-hospital mortality, all-cause mortality, and freedom from major adverse cardiac events between the groups, although cardiac-related deaths occurred only in group I (n = 5). Ipsilateral in situ grafts were associated with hemodialysis-induced chest pain (odds ratio, 5.528; 95% confidence interval, 1.079 to 28.333; p = 0.040). The incidence of dialysis-induced chest pain in patients with in situ noncomposite, in situ composite, and free grafts was 45.5%, 19.4%, and 5.7%, respectively (p = 0.009).
Conclusions: Mortality was not influenced by using the internal thoracic artery as an ipsilateral in situ graft in patients with upper extremity arteriovenous fistula. However, there was a risk of increased incidence of hemodialysis-induced chest pain that is most likely related to coronary steal. A free internal thoracic artery graft would be an alternative option in these patients.
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http://dx.doi.org/10.1016/j.athoracsur.2018.06.071 | DOI Listing |
Oper Neurosurg (Hagerstown)
January 2025
Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Am J Gastroenterol
January 2025
Department of Pediatric Surgery, Shanghai Key Laboratory of Birth Defect, Children's Hospital of Fudan University, Shanghai, China.
Cureus
December 2024
Department of Neurological Surgery, Rutgers University New Jersey Medical School, Newark, USA.
Arteriovenous fistulas of the filum terminale are rare vascular malformations that predominantly affect males and can present with various neurological symptoms. In this study, we indexed previously published cases of filum terminale arteriovenous fistulas demonstrating that endovascular and microsurgical management are both proven to be appropriate and successful treatment modalities with low complication rates. Endovascular treatment is far less invasive; however, it is associated with higher failure rates, which need to be managed surgically.
View Article and Find Full Text PDFFront Oncol
December 2024
Department of Neurosurgery, The Second Hospital of Lanzhou University, Lanzhou, China.
Scalp arteriovenous fistula (sAVF) is a rare disease caused by a congenital defect or exogenous injury, but no standard treatment exists. In this article, we report a rare case of sAVF combined with type C sAVF and cirsoid aneurysm (CA), which was successfully treated by staging microsurgery. Individualized surgical incisions were designed based on the size and range of the sAVF, and then staging microsurgery was performed.
View Article and Find Full Text PDFActa Med Philipp
November 2024
Division of Thoracic, Cardiac and Vascular Surgery, Department of Surgery, College of Medicine and Philippine General Hospital, University of the Philippines Manila.
Objective: To describe the treatment outcomes of patients who underwent Percutaneous Transluminal Angioplasty (PTA) for Central Vein Occlusive Disease (CVOD) in end-stage kidney disease and determine the association between patient profile and treatment outcomes.
Methods: A single-institution, retrospective review of patients aged 18 and above with end-stage kidney disease who underwent PTA for CVOD in the University of the Philippines - Philippine General Hospital (UP-PGH) from January 1, 2013, to December 31, 2022, was performed. These patients' demographic and clinical profiles were evaluated using means, frequencies, and percentages.
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