Distal-to-Snuffbox Arteriovenous Fistula
Abstract The dogma for optimal arteriovenous fistula (AVF) creation is based on starting as distally as possible on the upper limb and progressing proximally. We herein present our findings of an AVF that is as distal as possible on the hand. To document primary patency rates of the distal-to-snuffb...
Saved in:
Published in | The International journal of angiology Vol. 27; no. 4; pp. 227 - 231 |
---|---|
Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
333 Seventh Avenue, New York, NY 10001, USA
Thieme Medical Publishers
01.12.2018
|
Subjects | |
Online Access | Get full text |
Cover
Loading…
Abstract | Abstract
The dogma for optimal arteriovenous fistula (AVF) creation is based on starting as distally as possible on the upper limb and progressing proximally. We herein present our findings of an AVF that is as distal as possible on the hand. To document primary patency rates of the distal-to-snuffbox AVF. A 10-year prospective study (2006–2016) involving 31 patients whose distal cephalic vein diameter was ≥3 mm with a normal Allen's test was conducted. Patients were excluded if the radial artery in the wrist was highly calcified, the cephalic vein did not dilate more than 3 mm with proximal compression, and there was previously failed AVF of the limb or previous trauma to the limb. The procedure was performed under local anesthetic, and the anastomosis performed with a 6.0 polypropylene suture in an end-to-side fashion. Thirty-one patients with end-stage renal disease underwent distal vascular access using the distal-to-snuffbox (Hitchhiker's) AVF (HAVF). During follow-up, eight patients died with an adequately functioning HAVF. The primary patency rates at 12, 24, 48, and 60 months were 90, 87, 85, and 82%, respectively. Failure occurred in six (19%) cases over the follow-up period, two in the first 2 weeks and four over a span of 60 months.
Conclusion
The creation of radiocephalic AVFs in the first web space, distal to the tendon of the extensor pollicis longus, serves as a viable option with acceptable success rates. This allows the surgeon more options with proper patient selection for this procedure. |
---|---|
AbstractList | The dogma for optimal arteriovenous fistula (AVF) creation is based on starting as distally as possible on the upper limb and progressing proximally. We herein present our findings of an AVF that is as distal as possible on the hand. To document primary patency rates of the distal-to-snuffbox AVF. A 10-year prospective study (2006-2016) involving 31 patients whose distal cephalic vein diameter was ≥3 mm with a normal Allen's test was conducted. Patients were excluded if the radial artery in the wrist was highly calcified, the cephalic vein did not dilate more than 3 mm with proximal compression, and there was previously failed AVF of the limb or previous trauma to the limb. The procedure was performed under local anesthetic, and the anastomosis performed with a 6.0 polypropylene suture in an end-to-side fashion. Thirty-one patients with end-stage renal disease underwent distal vascular access using the distal-to-snuffbox (Hitchhiker's) AVF (HAVF). During follow-up, eight patients died with an adequately functioning HAVF. The primary patency rates at 12, 24, 48, and 60 months were 90, 87, 85, and 82%, respectively. Failure occurred in six (19%) cases over the follow-up period, two in the first 2 weeks and four over a span of 60 months.
The creation of radiocephalic AVFs in the first web space, distal to the tendon of the extensor pollicis longus, serves as a viable option with acceptable success rates. This allows the surgeon more options with proper patient selection for this procedure. The dogma for optimal arteriovenous fistula (AVF) creation is based on starting as distally as possible on the upper limb and progressing proximally. We herein present our findings of an AVF that is as distal as possible on the hand. To document primary patency rates of the distal-to-snuffbox AVF. A 10-year prospective study (2006–2016) involving 31 patients whose distal cephalic vein diameter was ≥3 mm with a normal Allen's test was conducted. Patients were excluded if the radial artery in the wrist was highly calcified, the cephalic vein did not dilate more than 3 mm with proximal compression, and there was previously failed AVF of the limb or previous trauma to the limb. The procedure was performed under local anesthetic, and the anastomosis performed with a 6.0 polypropylene suture in an end-to-side fashion. Thirty-one patients with end-stage renal disease underwent distal vascular access using the distal-to-snuffbox (Hitchhiker's) AVF (HAVF). During follow-up, eight patients died with an adequately functioning HAVF. The primary patency rates at 12, 24, 48, and 60 months were 90, 87, 85, and 82%, respectively. Failure occurred in six (19%) cases over the follow-up period, two in the first 2 weeks and four over a span of 60 months. Conclusion The creation of radiocephalic AVFs in the first web space, distal to the tendon of the extensor pollicis longus, serves as a viable option with acceptable success rates. This allows the surgeon more options with proper patient selection for this procedure. Abstract The dogma for optimal arteriovenous fistula (AVF) creation is based on starting as distally as possible on the upper limb and progressing proximally. We herein present our findings of an AVF that is as distal as possible on the hand. To document primary patency rates of the distal-to-snuffbox AVF. A 10-year prospective study (2006–2016) involving 31 patients whose distal cephalic vein diameter was ≥3 mm with a normal Allen's test was conducted. Patients were excluded if the radial artery in the wrist was highly calcified, the cephalic vein did not dilate more than 3 mm with proximal compression, and there was previously failed AVF of the limb or previous trauma to the limb. The procedure was performed under local anesthetic, and the anastomosis performed with a 6.0 polypropylene suture in an end-to-side fashion. Thirty-one patients with end-stage renal disease underwent distal vascular access using the distal-to-snuffbox (Hitchhiker's) AVF (HAVF). During follow-up, eight patients died with an adequately functioning HAVF. The primary patency rates at 12, 24, 48, and 60 months were 90, 87, 85, and 82%, respectively. Failure occurred in six (19%) cases over the follow-up period, two in the first 2 weeks and four over a span of 60 months. Conclusion The creation of radiocephalic AVFs in the first web space, distal to the tendon of the extensor pollicis longus, serves as a viable option with acceptable success rates. This allows the surgeon more options with proper patient selection for this procedure. Abstract The dogma for optimal arteriovenous fistula (AVF) creation is based on starting as distally as possible on the upper limb and progressing proximally. We herein present our findings of an AVF that is as distal as possible on the hand. To document primary patency rates of the distal-to-snuffbox AVF. A 10-year prospective study (2006–2016) involving 31 patients whose distal cephalic vein diameter was ≥3 mm with a normal Allen's test was conducted. Patients were excluded if the radial artery in the wrist was highly calcified, the cephalic vein did not dilate more than 3 mm with proximal compression, and there was previously failed AVF of the limb or previous trauma to the limb. The procedure was performed under local anesthetic, and the anastomosis performed with a 6.0 polypropylene suture in an end-to-side fashion. Thirty-one patients with end-stage renal disease underwent distal vascular access using the distal-to-snuffbox (Hitchhiker's) AVF (HAVF). During follow-up, eight patients died with an adequately functioning HAVF. The primary patency rates at 12, 24, 48, and 60 months were 90, 87, 85, and 82%, respectively. Failure occurred in six (19%) cases over the follow-up period, two in the first 2 weeks and four over a span of 60 months. Conclusion The creation of radiocephalic AVFs in the first web space, distal to the tendon of the extensor pollicis longus, serves as a viable option with acceptable success rates. This allows the surgeon more options with proper patient selection for this procedure. |
Author | Maharaj, Dale Ramdass, Michael James Budhoo, Emerson Baksh, Rayaad Oladiran, Adedapo |
AuthorAffiliation | 2 Department of Surgery, General Hospital Port-of-Spain, Port-of-Spain, Trinidad and Tobago 1 Caribbean Vascular and Vein Clinic, Port of Spain, Trinidad and Tobago |
AuthorAffiliation_xml | – name: 2 Department of Surgery, General Hospital Port-of-Spain, Port-of-Spain, Trinidad and Tobago – name: 1 Caribbean Vascular and Vein Clinic, Port of Spain, Trinidad and Tobago |
Author_xml | – sequence: 1 givenname: Dale surname: Maharaj fullname: Maharaj, Dale organization: Caribbean Vascular and Vein Clinic, Port of Spain, Trinidad and Tobago – sequence: 2 givenname: Michael James surname: Ramdass fullname: Ramdass, Michael James email: jimmyramdass@gmail.com organization: Department of Vascular Surgery, General Hospital Port of Spain – sequence: 3 givenname: Rayaad surname: Baksh fullname: Baksh, Rayaad organization: Department of Surgery, General Hospital Port-of-Spain, Port-of-Spain, Trinidad and Tobago – sequence: 4 givenname: Adedapo surname: Oladiran fullname: Oladiran, Adedapo organization: Department of Surgery, General Hospital Port-of-Spain, Port-of-Spain, Trinidad and Tobago – sequence: 5 givenname: Emerson surname: Budhoo fullname: Budhoo, Emerson organization: Caribbean Vascular and Vein Clinic, Port of Spain, Trinidad and Tobago |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30410295$$D View this record in MEDLINE/PubMed |
BookMark | eNp1kE1LAzEQhoNU7IdePUqPXlJnkibZvQilWhUKHtRzyKaJ3dJuSrJb9N-7pVX04GkG5nnfgadPOlWoHCGXCCMEIW4SBeAZRSkhA35CeihRUJHzvNPuIJGiQuySfkorAFRKijPS5TBGYLnokeu7MtVmTetAX6rG-yJ8DCexdrEMO1eFJg1nLdCszTk59Wad3MVxDsjb7P51-kjnzw9P08mcWp6LmjJmpS8cjjMuFfcewTMlrM0NSJ95xRQDg44bzIBZUGPRxgpm84XMfZvhA3J76N02xcYtrKvqaNZ6G8uNiZ86mFL_vVTlUr-HnZaMocqztmB0KLAxpBSd_8ki6L0znfTemT46awNXvz_-4N-SWoAegHpZuo3Tq9DEqnXwX-EXDrl2rw |
CitedBy_id | crossref_primary_10_1016_j_avsg_2019_10_101 crossref_primary_10_1016_j_avsg_2019_11_012 crossref_primary_10_1016_j_jvs_2021_01_069 |
ContentType | Journal Article |
Copyright | Thieme Medical Publishers |
Copyright_xml | – notice: Thieme Medical Publishers |
DBID | NPM AAYXX CITATION 5PM |
DOI | 10.1055/s-0038-1660803 |
DatabaseName | PubMed CrossRef PubMed Central (Full Participant titles) |
DatabaseTitle | PubMed CrossRef |
DatabaseTitleList | PubMed CrossRef |
Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database |
DeliveryMethod | fulltext_linktorsrc |
Discipline | Anatomy & Physiology |
EISSN | 1615-5939 |
EndPage | 231 |
ExternalDocumentID | 10_1055_s_0038_1660803 30410295 |
Genre | Case Reports |
GroupedDBID | --- -~C .86 0R~ 1SB 2.D 28- 29J 2JY 2P1 2VQ 4.4 53G 5GY 5QI 5VS 5~~ 6NX AAIAL AAPBV ABDBF ABMNI ABPTK ABTEG ACGFS ACUDM ADBBV ADIMF ADINQ ADKPE ADQRH AEFIE AEJHL AEKMD AFEXP AFLOW AGKHE AHBYD AHKAY AHMBA AHRAW AHSBF AIVKU AJGCD ALMA_UNASSIGNED_HOLDINGS AMKLP AMTXH BAWUL BBWZM BGNMA C45 CAG COF CS3 CSCUP DIK DL5 E3Z EBS EJD ESX EXEOM F5P FEDTE GRRUI GX1 H13 HF~ HG6 HYE HZ~ I09 IHE IY8 IZQ J5H KDC KOW LAS M4Y N2Q NDZJH NU0 O9- O93 O9G O9I OK1 OVD P19 PQEST PQQKQ Q3R QOK QOS QTC R4E RHV RIG ROL RPM RPX RSV RTC S26 S28 SCLPG SDE SDH SDM SMD T16 TEORI TR2 TSK TSV TUS U2A VC2 WJK WK8 ~8M ~EX ABJNI AFBBN HVGLF NPM AAYXX CITATION 5PM |
ID | FETCH-LOGICAL-c395t-22c6fbe1483673ff10f275cc9a06f8f72720a1e3a1802c0745395b2c9d69f8363 |
IEDL.DBID | RPM |
ISSN | 1061-1711 |
IngestDate | Tue Sep 17 21:27:19 EDT 2024 Thu Sep 12 20:06:45 EDT 2024 Sat Sep 28 08:37:01 EDT 2024 Fri Aug 04 23:39:34 EDT 2023 |
IsDoiOpenAccess | false |
IsOpenAccess | true |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 4 |
Keywords | hemodialysis kidney distal fistula vascular access |
Language | English |
LinkModel | DirectLink |
MergedId | FETCHMERGED-LOGICAL-c395t-22c6fbe1483673ff10f275cc9a06f8f72720a1e3a1802c0745395b2c9d69f8363 |
OpenAccessLink | https://europepmc.org/articles/pmc6221798?pdf=render |
PMID | 30410295 |
PageCount | 5 |
ParticipantIDs | pubmedcentral_primary_oai_pubmedcentral_nih_gov_6221798 crossref_primary_10_1055_s_0038_1660803 pubmed_primary_30410295 thieme_journals_10_1055_s_0038_1660803 |
PublicationCentury | 2000 |
PublicationDate | 2018-12-01 |
PublicationDateYYYYMMDD | 2018-12-01 |
PublicationDate_xml | – month: 12 year: 2018 text: 2018-12-01 day: 01 |
PublicationDecade | 2010 |
PublicationPlace | 333 Seventh Avenue, New York, NY 10001, USA |
PublicationPlace_xml | – name: 333 Seventh Avenue, New York, NY 10001, USA – name: United States |
PublicationTitle | The International journal of angiology |
PublicationTitleAlternate | Int J Angiol |
PublicationYear | 2018 |
Publisher | Thieme Medical Publishers |
Publisher_xml | – name: Thieme Medical Publishers |
SSID | ssj0017765 |
Score | 2.173288 |
Snippet | Abstract
The dogma for optimal arteriovenous fistula (AVF) creation is based on starting as distally as possible on the upper limb and progressing proximally.... The dogma for optimal arteriovenous fistula (AVF) creation is based on starting as distally as possible on the upper limb and progressing proximally. We herein... |
SourceID | pubmedcentral crossref pubmed thieme |
SourceType | Open Access Repository Aggregation Database Index Database Publisher |
StartPage | 227 |
SubjectTerms | Case Report |
Title | Distal-to-Snuffbox Arteriovenous Fistula |
URI | http://dx.doi.org/10.1055/s-0038-1660803 https://www.ncbi.nlm.nih.gov/pubmed/30410295 https://pubmed.ncbi.nlm.nih.gov/PMC6221798 |
Volume | 27 |
hasFullText | 1 |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3PS8MwFH7M4cGLqPPH_EUPMr1kbdombY9jOoYwEXSwW2nShA22drhO9L83SduxCV489z1SviS89_q-fg_gLsSYp5HjI0F4inzMKWJpkiDMeMS4y7g0lP_RCx2O_ecJmTSA1P_CGNI-Z7NuNl90s9nUcCuXC27XPDH7ddSnrqt1tuw92As8ry7Rq9ZBEJj5kbrUQTjAuFZqJMReId0IQ5hSlSfpCTqqllcBVs-W2ApKm0j0myW5X0xnYiG24s_gCA6rxNHqlS94DA2RnUCrl6miefFtdSxD5TTfyFvw8KizwjkqcvSWraVk-Zd2VIct_zSarNZAGaznySmMB0_v_SGqRiIg7kWkQK7LqWRC1TAeDTwpsSPdgHAeJQ6VoTRd1QQLL9HCblylB0S5MZdHKY2k8vHOoJnlmbgAizDdEwxCoW60z0KHMT9VvsyhkUs8J2zDfY1JvCyVL2LTsSYkXmlJ0TCugGzDeYnUxq7GtQ3BDoYbAy1qvftE7bURt672tg2dEu24ulOrPxa__PcSV3Cgsp-w5KZcQ7P4WIsblWEU7NacqB_ygcxR |
link.rule.ids | 230,315,733,786,790,891,27955,27956,53825,53827 |
linkProvider | National Library of Medicine |
linkToHtml | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3JTsMwEB2xSXBhX8qaAwIubmMndpIjAqqyFCGxiFsUO7Za0aaIpgj4emwnqQCJA5w9IyceOzOTeX4DsB9iLNLI9ZGkIkU-FgzxNEkQ5iLignChLOS_fc1a9_7FI32cAFrdhbGgfcG79azXr2fdjsVWPvdFo8KJNW7aJ4wQw7PVmIRpfV4JrZL0sngQBLaDpEl2EA4wrrgaKW0MkSmFIcyYjpRMDx2dzWsXa7pLfHFLY1_0Eyc5k3e6si-_eKDmAjxUz14AT57qo5zXxccPWsc_v9wizJcxqXNcDC_BhMyWYeU40_l4_905cCxK1P5-X4GjUxNw9lA-QLfZSCk-eDOKeh8PXi3dq9PUAqNesgr3zbO7kxYquy0g4UU0R4QIprjU6ZHHAk8p7CoSUCGixGUqVLZgm2DpJYYzTujIg2o1TkSUskhpHW8NprJBJjfAodyUG4NQ6o-Fz0OXcz_VutxlEaGeG9bgsFrs-Lkg1YhtMZzSeGjYSsO4tFAN1gsTjOUqg9Ug-GacsYDhy_4-olfa8maXK1uDg8KMcXlch79MvvnvKfZgtnXXvoqvzq8vt2BOB1lhAYHZhqn8ZSR3dCCT8127bT8Bfn7uSg |
linkToPdf | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1LT8MwDLZ4CXHh_RjPHhBwydqkTdoeETDxFhIgIS5VkyZiYusm1iHg15Ok7TSQuHCurbR2Etv1p88A-xHGIou9AEkqMhRgwRDP0hRhLmIuCBfKQv5vbtn5Y3D5RJ_GRn1Z0L7g7Wbe6Tbz9ovFVva7wq1xYu7dzQkjxPBsuf1MuZMwrc8sCetCvWoghKGdImkKHoRDjGu-RkrdATLtMIQZ09mSmaOjK3odZs2EibHQNIpHv7GSM8VLW3blWBRqLcBz_f4l-OS1OSx4U3z9onb81wcuwnyVmzrHpcgSTMh8GVaOc12Xdz-dA8eiRe1v-BU4OjWJZwcVPXSfD5XivQ-jqPdz793SvjotLTDspKvw2Dp7ODlH1dQFJPyYFogQwRSXukzyWegrhT1FQipEnHpMRco2blMs_dRwxwmdgVCtxomIMxYrreOvwVTey-UGOJSbtmMYSX1pBDzyOA8yrcs9FhPqe1EDDmuDJ_2SXCOxTXFKk4FhLY2SyksNWC_dMJKrndaA8IeDRgKGN_vnE21ty59dWbcBB6Urk-rYDv5YfPPfS-zB7N1pK7m-uL3agjmda0UlEmYbpoq3odzR-UzBd-3O_QYuovDK |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Distal-to-Snuffbox+Arteriovenous+Fistula&rft.jtitle=The+International+journal+of+angiology&rft.au=Maharaj%2C+Dale&rft.au=Ramdass%2C+Michael+James&rft.au=Baksh%2C+Rayaad&rft.au=Oladiran%2C+Adedapo&rft.date=2018-12-01&rft.issn=1061-1711&rft.volume=27&rft.issue=4&rft.spage=227&rft_id=info:doi/10.1055%2Fs-0038-1660803&rft_id=info%3Apmid%2F30410295&rft.externalDocID=30410295 |
thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1061-1711&client=summon |
thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1061-1711&client=summon |
thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1061-1711&client=summon |