Diameter measurements of the forearm cephalic vein prior to vascular access creation in end-stage renal disease patients: graduated pressure cuff versus tourniquet vessel dilatation

Arteriovenous fistula (AVF) is the “lifeline” for patients with end-stage renal disease (ESRD) undergoing hemodialysis. AVF maturation failure is a poorly understood process, one of the contributors being endothelial dysfunction due to oxidative stress. Monoamine oxidases (MAOs) A and B were recently identified as novel sources of vascular oxidative stress. The aim of the present study was to assess the contribution of MAOs to the endothelial dysfunction in patients with ESDR with indication of hemodialysis. Fragments of brachial artery collaterals were harvested from ESRD patients during the surgical procedure aimed at creating the vascular access in the cubital fossa. The effect of increasing concentrations (10, 30, 100 μmol/L) of the irreversible MAO-A inhibitor, clorgyline, and MAO-B inhibitor, selegiline, on endothelial-dependent relaxation (EDR) in response to cumulative doses of acetylcholine was studied in isolated phenylephrine-preconstricted vascular rings. Hydrogen peroxide (H2O2) production was assessed using ferrous oxidation xylenol orange assay. We showed that incubation of brachial rings with MAO inhibitors significantly improved EDR and attenuated H2O2 generation in patients with ESRD. MAO-related oxidative stress might contribute to the primary dysfunction/non-maturation of the AVF and MAO inhibitors could improve maturation and long-term patency of the vascular access in dialysis patients.

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PERSENTASE KEBERHASILAN OPERASI CIMINO DAN AV-SHUNT CUBITI PADA PASIEN HEMODIALISA DI RSUP PROF KANDOU PERIODE JANUARI 2013 – DESEMBER 2013

e-CliniC ◽

10.35790/ecl.2.1.2014.3673 ◽

2014 ◽

Vol 2 (1) ◽

Author(s):

Cliff W. Sulangi

Keyword(s):

Renal Failure ◽

Chronic Renal Failure ◽

Renal Disease ◽

Vascular Access ◽

End Stage Renal Disease ◽

Research Subjects ◽

Stage Renal Disease ◽

End Stage ◽

Av Shunt ◽

Success Percentage

Abstract: The procedure of access hemodialysis is a vascular surgical procedure. Vascular access is indicated in patients with end stage renal disease (ESRD) or patients with end stage chronic renal failure and had to take process on hemodialysis. Cimino and AV-Shunt cubiti is two techniques of vascular access operation. This research aims to know the percentage of successful cimino and av-shunt cubiti operation in RSUP Prof Kandou at 2013. This research was conducted using a retrospective descriptive methods. This research subjects were 37 patients. 22 patients with cimino and 15 patient with av-shunt cubiti. The result of this research obtained success percentage use 63,6 % of cimino and the percentage of successful use of av-shunt cubiti is 66,7%. Key words: Vascular access, Ciminom av-shunt cubiti, successful percentage Abstrak: Prosedur dari akses hemodialisa merupakan prosedur operasi vaskular. Akses vaskular diindikasikan pada pasien dengan end stage renal disease (ERSD) atau pasien dengan gagal ginjal kronik stadium akhir dan harus menjalani proses hemodialisa. Operasi Cimino dan AV-Shunt Cubiti merupakan dua teknik operasi akses vaskular. Penelitian ini bertujuan untuk mengetahui prosentase keberhasilan operasi Cimino dan AV-shunt cubiti pada pasien hemodialisa di RSUP Prof Kandou tahun 2013. Penelitian ini dilakukan menggunakan metode deskriptif retrospektif. Subyek penelitian Berjumlah 37 pasien. 22 pasien operasi Cimino dan 15 pasien dengan AV-Shunt cubiti. Hasil penelitian ini didapatkan Prosentase keberhasilan penggunaan Cimino sebesar 63,6 % dan prosentase keberhasilan penggunaan AV-Shunt cubiti sebesar 66,7%. Kata Kunci: Akses vaskular, Operasi Cimino, AV-shunt cubiti, prosentase keberhasilan

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Axillary artery loop interposition graft (AALG) as unusual access for hemodialysis

International Surgery Journal ◽

10.18203/2349-2902.isj20175154 ◽

2017 ◽

Vol 4 (12) ◽

pp. 3853

Author(s):

Abdelmieniem Fareed ◽

Nehad Zaid ◽

Yahia M. Alkhateep

Keyword(s):

Renal Disease ◽

Vascular Access ◽

End Stage Renal Disease ◽

Axillary Artery ◽

Severe Infection ◽

Cardiac Insufficiency ◽

Secondary Patency ◽

Efficient Alternative ◽

Stage Renal Disease ◽

End Stage

Background: Life expectancy of end stage renal disease patients continues to lengthen and with the limited durability of vascular accesses, repeat fistula construction at different levels of the upper limb is often necessary and leads ultimately to exhaustion of autogenous vascular access sites. Our experience with alternative vascular access procedures namely the arterio-arterial loop graft in the first part of axillary artery was presented in this study.Methods: From June 2013 to Aug 2017, arterio-arterial interposition loop graft procedures (AALG) for vascular access were performed in 15 patients with end-stage renal disease. Inclusion criteria were patients with unsuitable large deep veins or with cardiac insufficiency intolerable to high-flow arterio-venous fistula.Results: The achieved primary and secondary patency was 73.3 % and 86.6% at 1 year and 53.3 % and 66.7 % at 3 years. Severe infection in whole graft occurred in two patients (13.3%) after 11, 27 months. One patient died six months after operation due to unrelated cause. two patients had pseudoaneurysms after 20 and 28 months at sites of repetitive needle puncture and were treated successfully by segmental replacement.Conclusions: In selected cases and with proper indication the AALG can offer efficient alternative for vascular hemodialysis access and can improve the survival rate of such patients.

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