Sie können Bookmarks mittels Listen verwalten, loggen Sie sich dafür bitte in Ihr SLUB Benutzerkonto ein.
Medientyp:
E-Artikel
Titel:
Minimally Invasive Basilic Vein Harvest for Arteriovenous Fistula Transposition using a Laryngoscope
Beteiligte:
Jennings, William C.;
Blebea, John;
Arcos, V. Karlos;
Maliska, Miles;
Fadner, Brandon;
Nguyen, Albert
Erschienen:
SAGE Publications, 2012
Erschienen in:
The Journal of Vascular Access, 13 (2012) 4, Seite 508-512
Sprache:
Englisch
DOI:
10.5301/jva.5000085
ISSN:
1724-6032;
1129-7298
Entstehung:
Anmerkungen:
Beschreibung:
Purpose The standard lengthy surgical incision used for basilic vein arteriovenous fistula (AVF) transposition is associated with significant discomfort, scarring and risk of wound complications. Minimally invasive vein dissection using a laryngoscope is an inexpensive alternative which has been successfully used for saphenous vein harvesting and which we have applied to the basilic vein for laryngoscopic-assisted AVF transposition (L-AVF/T). Methods During this technique, the basilic vein is mobilized through two small incisions, one in the axilla and the second just proximal to the cubital fossa. Ultrasound examination is used to map the location of the largest distal venous branch, either the forearm basilic vein or the median cubital vein. An important element of exposure is incising the superficial investing fascia longitudinally over the vein, allowing the working space to expand. Results L-AVF/Ts were constructed in 47 patients during a 20 month time period. Mean age was 62 (18–87) years. Twenty-five (53%) patients were women, sixteen (34%) were obese and twenty-eight (60%) were diabetic. All veins were successfully harvested and there were no neurologic injuries. Primary and cumulative patency rates were 80% and 92%, respectively, at one year with follow-up ranging between 1–20 months (mean = 4 months). Conclusions Minimally invasive dissection of the basilic vein for vascular access transposition using laryngoscopic assistance is safe, reliable and cost efficient with good short-term patency and functional outcomes.