Venous outflow banding for maturation of a percutaneous arteriovenous fistula

We present the case of a 21-year-old male with significant lengthening and aneurysmal degeneration of his brachiocephalic arteriovenous fistula resulting in a megafistula and high-output cardiac failure. A computed tomography angiogram showed narrowing at the cephalic arch. Further evaluation during the operation revealed kinking and elongation of the fistula in addition to compression of the cephalic arch in the deltopectoral groove leading to outflow obstruction. The aneurysmal fistula was treated successfully with aneurysmorrhaphy of the remaining conduit and banding of the inflow. This case demonstrates a unique etiology of venous outflow obstruction for a fistula and describes the surgical approach to its treatment in a young patient suffering from cardiac failure.

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Long-Term Results of Thrombectomy with Temporary Arteriovenous Fistula for Ileofemoral Venous Thrombosis

Phlebology The Journal of Venous Disease ◽

10.1177/026835558600100204 ◽

1986 ◽

Vol 1 (2) ◽

pp. 113-117 ◽

Cited By ~ 2

Author(s):

S. Zetterquist ◽

R. Hägglöf ◽

H. Jacobsson ◽

J. Johansson ◽

H. Johnsson ◽

...

Keyword(s):

Venous Thrombosis ◽

Arteriovenous Fistula ◽

Long Term Results ◽

Anticoagulant Treatment ◽

Venous Outflow ◽

Temporary Arteriovenous Fistula ◽

Distal Extension ◽

Valvular Insufficiency

Nineteen patients with acute ileofemoral venous thrombosis were subjected to thrombectomy with the addition of a temporary a-v fistula and anticoagulant treatment. At follow-up 3 years after surgery isotope phlebography disclosed more-or-less patent ileofemoral segments in 16 patients. The venous outflow capacity as estimated from venous emptying curves was normal in all but three totally occluded limbs, indicating an adequate collateral compensation. Foot volumetry demonstrated signs of venous valvular insufficiency, mainly in legs with a distal extension of the initial thrombosis; these patients complained of symptoms of post-thrombotic syndrome, which emphasizes the importance of early operation.

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Intracranial Venous Hypertension and the Effects of Venous Outflow Obstruction in a Rat Model of Arteriovenous Fistula

Neurosurgery ◽

10.1227/00006123-199109000-00002 ◽

1991 ◽

Vol 29 (3) ◽

pp. 341-350 ◽

Cited By ~ 62

Author(s):

Joshua B. Bederson ◽

Otmar D. Wiestler ◽

Oliver Brüstle ◽

Peter Roth ◽

Rosmarie Frick ◽

...

Keyword(s):

Arteriovenous Fistula ◽

Rat Model ◽

Venous Hypertension ◽

Outflow Obstruction ◽

Venous Outflow ◽

Venous Outflow Obstruction

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Preoperative Ultrasound Assessment for Dialysis Access Placement

Journal for Vascular Ultrasound ◽

10.1177/154431670502900304 ◽

2005 ◽

Vol 29 (3) ◽

pp. 131-136

Author(s):

M. Ann Needham

Keyword(s):

Renal Failure ◽

Arteriovenous Fistula ◽

Flow Diagram ◽

Dialysis Access ◽

Venous Outflow ◽

The Status ◽

Arterial Inflow ◽

History Of ◽

Ultrasound Assessment ◽

Steal Syndrome

Vascular access includes any form of cannulation of arteries or veins. For the treatment of chronic renal failure, this term refers to the ability to access both the arterial inflow and the venous outflow for the purpose of replacing the function of the kidney. This work provides a brief review of the history of hemodialysis and presents the method we use currently to map the arterial and venous system prior to placement of an arteriovenous fistula. The purpose is to present the process we use to determine the status of the arteries and the venous patency, as well as the flow diagram we use to determine the steps taken for each patient referred for preoperative vein mapping, including the worksheet used to collect the information for the surgeon. This work presents the minimum prerequisites that are thought to be necessary to create a viable arteriovenous fistula. A brief discussion of the criteria and protocol is presented that is used to diagnose steal syndrome from the hand. Billing codes are included when this procedure is used.

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