alexa Vascular complications of native arteriovenous fistulas for hemodialysis: role of microsurgery.
Surgery

Surgery

Journal of Vascular Medicine & Surgery

Author(s): Cavallaro G, Taranto F, Cavallaro E, Quatra F

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Abstract This article describes the treatment of 56 early and late vascular complications of native arteriovenous fistula (AVF) in patients with end-stage renal disease, between January 1987 and January 1999. Twenty-six were arteriovenous aneurysms and 2 pseudoaneurysms; 25 were thromboses. We also observed two cases of periarteritis associated with systemic lupus erythematosus (SLE) and one complex iatrogenic lesion caused by an attempt at percutaneous restoration of potency. We applied microsurgical principles, instruments, and techniques. It was possible to restore a vascular access at the original site, using the same vessels in 45 cases (80.4\%). In 10.7\% of cases, we were able to rescue the original AVF by microsurgical revision. A new vascular access had to be created proximally in the same limb or in the contralateral forearm in 11 cases of aneurysms (19.6\% of the total, 42\% of the aneurysms). After a minimum follow-up of 8 months, a total of four patients had to be reoperated for further complications (7.2\%). Our data support the idea that microsurgical treatment of vascular complications of native AVF is highly successful compared with results obtained by conventional surgery and, in a defined subgroup of patients, permits salvage of the fistula. Copyright 2000 Wiley-Liss, Inc.
This article was published in Microsurgery and referenced in Journal of Vascular Medicine & Surgery

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