Objective: Flow reduction is required to preserve vascular access in cases with high flow access (HFA). We report a new flow reduction procedure, the graft inclusion technique (GIT). Methods: The GIT procedure developed by us involves the intraluminal placement and suturing of a 4-mm polytetrafluoroethylene graft to the anastomosis and outflow tract to plicate the enlarged anastomosis and maintain lower flow volumes. Flow reduction for HFA was retrospectively assessed in a series of 25 patients (age 65±12 years; 17 males and 8 females) to evaluate flow volume and patency rate, wherein 10 patients underwent conventional methods of flow reduction and 15 underwent GIT. Results: Compared with preprocedure values, mean flow volume (MFV) was significantly lower after the procedure with both the conventional methods (1,817 vs. 586 ml/min; P<0.05) and the GIT (2,262 vs. 890 ml/min; P<0.05). An increase in MFV occurred during follow-up after conventional flow reduction (586 vs. 1,036 ml/min), while GIT could maintain lower MFV (890 vs. 791 ml/min), suggesting that GIT can significantly lower MFV levels (2,262 vs. 791 ml/min; P<0.05) and maintain these lower MFV levels during follow-up. Secondary patency rate for the GIT was 100% at 1 year and 83% at 3 years. Conclusion: The GIT may be used as an access-preserving, reliable, long-term, and stable flow-reducing procedure that does not require flow adjustment during surgery.
Objective: Flow reduction is required to preserve vascular access in cases with high flow access (HFA). We report a new flow reduction procedure, the graft inclusion technique (GIT). Methods: The GIT procedure developed by us involves the intraluminal placement and suturing of a 4-mm polytetrafluoroethylene graft to the anastomosis and outflow tract to plicate the enlarged anastomosis and maintain lower flow volumes. Flow reduction for HFA was retrospectively assessed in a series of 25 patients (age 65±12 years; 17 males and 8 females) to evaluate flow volume and patency rate, wherein 10 patients underwent conventional methods of flow reduction and 15 underwent GIT. Results: Compared with preprocedure values, mean flow volume (MFV) was significantly lower after the procedure with both the conventional methods (1,817 vs. 586 ml/min; P<0.05) and the GIT (2,262 vs. 890 ml/min; P<0.05). An increase in MFV occurred during follow-up after conventional flow reduction (586 vs. 1,036 ml/min), while GIT could maintain lower MFV (890 vs. 791 ml/min), suggesting that GIT can significantly lower MFV levels (2,262 vs. 791 ml/min; P<0.05) and maintain these lower MFV levels during follow-up. Secondary patency rate for the GIT was 100% at 1 year and 83% at 3 years. Conclusion: The GIT may be used as an access-preserving, reliable, long-term, and stable flow-reducing procedure that does not require flow adjustment during surgery.
Entities:
Keywords:
flow reduction procedure; hemodialysis access-induced distal ischemia; high flow vascular access; high output heart failure; venous hypertension
Authors: P Bourquelot; J Gaudric; L Turmel-Rodrigues; G Franco; O Van Laere; A Raynaud Journal: Eur J Vasc Endovasc Surg Date: 2010-03-31 Impact factor: 7.069
Authors: Spyros I Papadoulas; Natasa Kouri; Andreas Tsimpoukis; Panagiotis Kitrou; Marios Papasotiriou; Konstantinos M Nikolakopoulos; Georgios-Ioannis Verras; Ioannis Panagiotopoulos; Francesk Mulita; Konstantinos G Moulakakis Journal: Kardiochir Torakochirurgia Pol Date: 2022-10-08