Implanted blood vessel external support device for the treatment of distal hypoperfusion ischemic syndrome in arteriovenous fistulas and high-frame-rate Vector Flow quality assessment.
J Vasc Access
; 25(2): 642-650, 2024 Mar.
Article
en En
| MEDLINE
| ID: mdl-36708038
ABSTRACT
INTRODUCTION:
Distal hypoperfusion ischemic syndrome (DHIS) is a complication occurring after arteriovenous fistula (AVF) creation. Different surgical alternatives haves been proposed in case of severe DHIS. Aim of the present paper is to present a new technique for DHIS treatment. MATERIAL ANDMETHODS:
Between the 1st of January 2021 and the 31st December 2021 all the patients referred to our center for DHIS grade 2-4 were treated with a new surgical technique. It consists of AVF remodeling using an external nitinol support (VasQ®) to reduce the risk of outflow vein enlargement and DHIS recurrence. To better appreciate the hemodynamic effects of the surgery, a new ultrasound technique called high-frame-rate Vector Flow (HiFR-VF) was used.RESULTS:
Seven patients (MF 13; mean age 43 ± 12 years, range 29-65) were included in this study. Central line was never necessary, and technical success was 100% at 12 months. The comparison with historical data demonstrated lower recurrence of symptoms in comparison to simple artery-to-vein redo (p 0.50). The HiFR-VF showed flow with limited turbulent characteristics at the anastomosis site. DISCUSSION ANDCONCLUSION:
The new technique proposed demonstrated to be safe and effective for treatment of DHIS, preventing symptoms recurrence. Ultrasound examination and HiFR-VF can be considered a valuable method to evaluate complex flows at the levels of vascular anastomosis.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Derivación Arteriovenosa Quirúrgica
/
Fístula Arteriovenosa
Límite:
Adult
/
Aged
/
Humans
/
Middle aged
Idioma:
En
Revista:
J Vasc Access
Asunto de la revista:
ANGIOLOGIA
Año:
2024
Tipo del documento:
Article
País de afiliación:
Italia