S Pantea1, L Jiga, M Ionac, F Lazar. 1. Second Surgery Department, V.Babes University of Medicine and Pharmacy, Timisoara, Romania. stepan62@yahoo.com
Abstract
UNLABELLED: Vascular access in haemodialysis is still accompanied by a high morbidity rate. Neointimal hyperplasia due to thrombosis is one of the main causes of vascular access failure. The purpose of this paper is to present the use of non-penetrating titanium clips (VCS) for the creation of an arteriovenous fistula and its outcome. MATERIALS AND METHODS: A male patient, 47 years old, with end-stage renal disease - ESRD - (2005) was addressed to our service, for a vascular access reintervention, after a failed forearm radio-cephalic fistula performed 3 months before. In January 2007, an arteriovenous fistula between the brachial artery and the median cubital vein using non-penetrating titanium clips (Anastoclip VCS) was created. RESULTS: The vascular anastomosis was performed in 17 min. After unclamping the artery, a solid pulse and consistent thrill were obtained at the level of the cubital fossa. The postoperative course was uneventful. The arteriovenous fistula remains functional 60 months post-surgery. CONCLUSIONS: The Anastoclip VCS system is versatile, safe to manipulate and enables fast anastomosis. Arteriovenous anastomosis performed with non-penetrating clips may be a solution with the potential to reduce postoperative complications and extend arteriovenous fistula patency in ESRD. Celsius.
UNLABELLED: Vascular access in haemodialysis is still accompanied by a high morbidity rate. Neointimal hyperplasia due to thrombosis is one of the main causes of vascular access failure. The purpose of this paper is to present the use of non-penetrating titanium clips (VCS) for the creation of an arteriovenous fistula and its outcome. MATERIALS AND METHODS: A male patient, 47 years old, with end-stage renal disease - ESRD - (2005) was addressed to our service, for a vascular access reintervention, after a failed forearm radio-cephalic fistula performed 3 months before. In January 2007, an arteriovenous fistula between the brachial artery and the median cubital vein using non-penetrating titanium clips (Anastoclip VCS) was created. RESULTS: The vascular anastomosis was performed in 17 min. After unclamping the artery, a solid pulse and consistent thrill were obtained at the level of the cubital fossa. The postoperative course was uneventful. The arteriovenous fistula remains functional 60 months post-surgery. CONCLUSIONS: The Anastoclip VCS system is versatile, safe to manipulate and enables fast anastomosis. Arteriovenous anastomosis performed with non-penetrating clips may be a solution with the potential to reduce postoperative complications and extend arteriovenous fistula patency in ESRD. Celsius.