Vascular access in patients with arterial insufficiency. Construction of proximal bridge fistulae based on inflow from axillary branch arteries.
Vascular access in patients with arterial insufficiency. Construction of proximal bridge fistulae based on inflow from axillary branch arteries.
复制标题
动脉供血不足患者的血管通路。
DOI：
10.1097/00000658-199008000-00012
复制
发表时间：
1990
影响因子：
9
通讯作者：
Anderson,CB
中科院分区：
文献类型：
--
作者：
Jendrisak,MD;Anderson,CB
肾功能衰竭和潜在的外周血管疾病的患者在建立长期血管通路进行慢性血液透析时构成了一个困难的管理问题。本报告总结了我们的经验，五个衰弱的病人谁开发急性上肢缺血后，前臂瘘建设纠正瘘结扎。通过基于腋动脉的分支动脉构建动脉流入的近端桥瘘，成功实现了血管通路，没有缺血复发。相对较小的分支血管是限制瘘流而允许正常远端腋动脉血流的主要因素。在4例患者中，直接瘘管流量测量值范围为200 mL/min至620 mL/min。瘘管远端的腋动脉流量范围为每分钟120至200毫升，在瘘管构建后或瘘管暂时闭塞期间没有显着变化。5例患者中有4例在4至8.5个月内继续顺利透析。1例患者于术后1个月停止透析后死亡。图像
Patients with renal failure and underlying peripheral vascular disease pose a difficult management problem in establishing long-term angioaccess for chronic hemodialysis. This report summarizes our experience with five debilitated patients who developed acute upper extremity ischemia after forearm fistula construction corrected by fistula ligation. Successful angioaccess was achieved without ischemia recurrence by construction of proximal bridge fistulae with arterial inflow based on branch arteries of the axillary artery. The relatively small size of the branch vessel was the main factor in limiting fistula flow while permitting normal distal axillary artery flow. In four patients direct fistula flow measurements ranged from 200 mL per minute to 620 mL per minute. Axillary arterial flow distal to the fistula ranged from 120 to 200 mL per minute and did not significantly change after fistula construction or during temporary occlusion of the fistula. Four of the five patients continue to dialyze uneventfully from 4 to 8.5 months. One patient died after discontinuation of dialysis 1 month after operation. Images