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Complications of Arteriovenous Fistulas for Hemodialysis

Complications of Arteriovenous Fistulas for Hemodialysis Abstract Thirty vascular complications were seen in a group of 444 patients who had 516 arteriovenous fistulas for hemodialysis: 413 standard peripheral arteriovenous fistulas and 103 modifications, which included the use of 35 autogenous vein grafts and 62 bovine heterografts. Four hundred sixty-two of the fistulas were done with the radial or ulnar arteries, 53 with the brachial artery, and one with the superficial femoral artery. Symptomatic ischemia due to "steal" developed in eight patients (1.6%). Four of these patients developed gangrene, with one requiring finger amputation and three of them hand amputation. False aneurysms developed in 14 patients, ten infectious and four traumatic. Venous aneurysm requiring surgery developed in four patients and hand venous hypertension syndrome with chronic venous stasis in the hand was seen in four patients. References 1. Brescia MJ, Cimino JE, Appel K, et al: Chronic hemodialysis using venapuncture and a surgically created arterio-venous fistula . N Engl J Med 275:1089-1092, 1966.Crossref 2. May J, Tiller D, Johnson J, et al: Saphenous vein arteriovenous fistula in regular dialysis treatment . N Engl J Med 280:770, 1969.Crossref 3. Haimov M, Burrows L, Casey JD, et al: Vascular access for hemodialysis: Experience with 214 patients: Special problems and causes for early and late failures . Proc Europ Dial Transplant Assoc 9:173-178, 1973. 4. Buselmeier TJ, Kjellstrand CM, Rattazzi LC, et al: The A-V fistula in the diabetic: Ischemia and gangrene resulting in amputation , abstracted. Clin Dial Transplant Forum 2:6, 1972. 5. Kinnaert P, Geens M, Vereerstraeten P, et al: Experience with arteriovenous fistulas in chronic hemodialysis . Am J Surg 122:104-108, 1971.Crossref 6. Buselmeier TJ: Unique modes of vascular access . North Cent Dial Transplant Forum 11:1-2, 1972. 7. Haimov M, Burrows L, Baez A, et al: Alternatives for vascular access for hemodialysis: Experience with autogenous saphenous vein autografts and bovine heterografts . Surgery 74:447-452, 1974. 8. Matolo N, Kastagir B, Stevens L, et al: Neurovascular complications of brachial arteriovenous fistula . Am J Surg 121:716-719, 1971.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Complications of Arteriovenous Fistulas for Hemodialysis

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Publisher
American Medical Association
Copyright
Copyright © 1975 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1975.01360120026004
Publisher site
See Article on Publisher Site

Abstract

Abstract Thirty vascular complications were seen in a group of 444 patients who had 516 arteriovenous fistulas for hemodialysis: 413 standard peripheral arteriovenous fistulas and 103 modifications, which included the use of 35 autogenous vein grafts and 62 bovine heterografts. Four hundred sixty-two of the fistulas were done with the radial or ulnar arteries, 53 with the brachial artery, and one with the superficial femoral artery. Symptomatic ischemia due to "steal" developed in eight patients (1.6%). Four of these patients developed gangrene, with one requiring finger amputation and three of them hand amputation. False aneurysms developed in 14 patients, ten infectious and four traumatic. Venous aneurysm requiring surgery developed in four patients and hand venous hypertension syndrome with chronic venous stasis in the hand was seen in four patients. References 1. Brescia MJ, Cimino JE, Appel K, et al: Chronic hemodialysis using venapuncture and a surgically created arterio-venous fistula . N Engl J Med 275:1089-1092, 1966.Crossref 2. May J, Tiller D, Johnson J, et al: Saphenous vein arteriovenous fistula in regular dialysis treatment . N Engl J Med 280:770, 1969.Crossref 3. Haimov M, Burrows L, Casey JD, et al: Vascular access for hemodialysis: Experience with 214 patients: Special problems and causes for early and late failures . Proc Europ Dial Transplant Assoc 9:173-178, 1973. 4. Buselmeier TJ, Kjellstrand CM, Rattazzi LC, et al: The A-V fistula in the diabetic: Ischemia and gangrene resulting in amputation , abstracted. Clin Dial Transplant Forum 2:6, 1972. 5. Kinnaert P, Geens M, Vereerstraeten P, et al: Experience with arteriovenous fistulas in chronic hemodialysis . Am J Surg 122:104-108, 1971.Crossref 6. Buselmeier TJ: Unique modes of vascular access . North Cent Dial Transplant Forum 11:1-2, 1972. 7. Haimov M, Burrows L, Baez A, et al: Alternatives for vascular access for hemodialysis: Experience with autogenous saphenous vein autografts and bovine heterografts . Surgery 74:447-452, 1974. 8. Matolo N, Kastagir B, Stevens L, et al: Neurovascular complications of brachial arteriovenous fistula . Am J Surg 121:716-719, 1971.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Jun 1, 1975

References