The creation of an arteriovenous fistula instead of a synthetic vascular graft is a smart decision in hemodialysis patients who do not have a suitable superficial vein. Basilic vein transposition (BVT) is a viable option in most cases, except in patients who do not have a proper basilic vein. In patients with inadequate superficial veins, another source of the autogenous vein is the brachial vein, a deep vein of the upper arm. Most surgeons choose a full medial arm incision to perform brachial vein exploration. We describe a patient in whom BVT was not possible and so brachial vein transposition using skip incisions was performed, with good results.
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http://dx.doi.org/10.5758/vsi.200060 | DOI Listing |
Cureus
November 2024
Department of Orthopedic Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, USA.
This review addresses the neurovascular complications associated with the surgical treatment of clavicle fractures through open reduction and internal fixation (ORIF). Despite being a generally safe procedure, it can lead to severe complications including brachial plexopathy, pseudoaneurysm, arteriovenous fistulas (AVF), deep vein thrombosis (DVTs), and thoracic outlet syndrome (TOS). One significant observation, not often highlighted in previous literature, is that neurovascular complications are more common in cases involving delayed fixation, nonunion, or malunion, compared to those treated acutely.
View Article and Find Full Text PDFJ Reconstr Microsurg
December 2024
Department of Medical Pathology, Hospital of Büyükşehir, Nevşehir, Turkey.
Background: Pedicled, prefabricated, and free nerve flaps have several drawbacks, such as requiring microsurgical anastomosis, the need for secondary operations and the risk of developing thrombosis. In this study, we aimed to vascularize the repaired nerve in a single session by establishing a connection between the epineurium of the repaired median nerve and the tunica adventitia of the brachial artery.
Methods: The technique was performed on the median nerves of a total of 42 rats over 13 weeks.
Vascular
December 2024
Department of Nephrology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Objective: investigate the timing of assessing the maturation of arteriovenous fistula (AVF) and the diagnostic efficacy of two ultrasound assessment criteria in determining the maturation of AVF.
Methods: We collected clinical data on 227 patients with end-stage renal disease who were first diagnosed at our institution between February 1, 2023 and February 1, 2024, and were followed up regularly for 12 weeks post-AVF creation, with the diameter of the draining vein and the brachial artery volume flow (VF) recorded at 1 day, 2, 4, 6, 8, 10, and 12 weeks post-operation. We focused on the time of AVF maturation, and ultrasonographic diagnostic criteria 1 (the vein diameter was ≥4 mm, and the brachial artery VF was >500 mL/min, referred to as the "Rule of 4") and ultrasonographic diagnostic criteria 2 (the vein diameter was ≥5 mm, and the brachial artery VF was> 500 mL/min, referred to as the "Rule of 5") were used to evaluate the maturation of AVF.
Clin J Gastroenterol
December 2024
Department of Nephrology, Saiseikai Niigata Kenoh Kikan Hospital, Sanjo, Niigata, 955-0091, Japan.
Intestinal fatty acid-binding protein (I-FABP) is a promising biomarker for small-bowel ischemia including non-occlusive mesenteric ischemia (NOMI). A 75-year-old woman with diabetic nephropathy sustained a distal radius fracture. Two days later, she underwent a brachial plexus block to facilitate orthopedic surgery, which resulted in hypotension.
View Article and Find Full Text PDFVascular
December 2024
Department of Vascular Surgery, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
Objectives: Basilic vein transposition (BVT) surgery is a crucial option for vascular access in hemodialysis patients when other alternatives are unavailable. One of the primary complications affecting the long-term function of arteriovenous fistulas (AVFs) is the development of pseudoaneurysms, often caused by repeated punctures at the same site. This study aims to evaluate whether increasing the length of the basilic vein available for cannulation during the second stage of BVT surgery reduces the risk of puncture-related pseudoaneurysms, thereby improving fistula longevity and functionality.
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