Abstract：
OBJECTIVE:Almost two million individuals are undergoing renal replacement therapy worldwide, with hemodialysis being the common form. Many factors influence the primary patency of an arteriovenous fistula (AVF), including vessel size, fistula flow rates, cannulation practice, and thrombotic tendencies. Excess dilation of the AVF, resulting in the development of a megafistula, is a complication that can result in a need for AVF revision and subsequent failure. METHODS:The charts of patients who underwent autogenous AVF revision because of the development of a megafistula with aneurysmectomy and vein transposition by a single surgeon during a 7-year period from 2009 through 2016 were reviewed. A technique is described in which after aneurysmorrhaphy, the repaired venous component of the AVF is transposed through a new tunnel while the vein is rotated 90 degrees. This allows the AVF to be accessed immediately, making placement of a tunneled dialysis catheter unnecessary. RESULTS:There were 102 patients included in the study, with follow-up ranging from 7 to 95 months. In our cohort, 92 of the 102 revised AVFs (90.2%) maintained primary functional patency. Of the 102 patients who underwent this revision technique, there were 10 fistulas that subsequently failed after a mean of 29 months. There were only seven patients who experienced recurrent fistula dilation requiring repeated aneurysmectomy. CONCLUSIONS:We describe a technique for management of the development of a megafistula that uses only autogenous tissue and, perhaps most important, eliminates the need for temporary dialysis catheter placement.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Nezakatgoo N,Kozusko SD,Watson JT,Empting R,Shahan CP,Rohrer MJdoi
10.1016/j.jvs.2017.12.068subject
Has Abstractpub_date
2018-09-01 00:00:00pages
843-848issue
3eissn
0741-5214issn
1097-6809pii
S0741-5214(18)30266-0journal_volume
68pub_type
杂志文章abstract：OBJECTIVE:Treatment of type B aortic dissections with thoracic endovascular aortic repair (TEVAR) has been adopted in many centers with the goal of covering the proximal entry tear. Coverage of the left subclavian artery (LSCA) is commonly required to achieve a dissection-free proximal seal zone. A novel thoracic singl...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2019.04.461
更新日期：2019-12-01 00:00:00
abstract：BACKGROUND:Endovascular aortic aneurysm repairs (EVARs) with fenestrated (FEVAR) stent grafts are high radiation dose cases, yet no skin injuries were found retrospectively in our 61 cases with a mean peak skin dose (PSD) of 6.8 Gy. We hypothesize that skin injury is under-reported. This study examined deterministic ef...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2014.11.044
更新日期：2015-04-01 00:00:00
abstract：OBJECTIVE:Aortoaortic tube graft repair was the first technique used for the endovascular treatment of abdominal aortic aneurysms (AAAs). However, progressive changes in the morphology of the distal aortic neck may be responsible for procedural failure. This study examines the use of aortoaortic tube prostheses and ana...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1067/mva.2002.123684
更新日期：2002-05-01 00:00:00
abstract：PURPOSE:The role of arterial stenting in the treatment of femoral and popliteal arterial disease is controversial and has been hampered by recommendations for patients to be given anticoagulants (oral warfarin) for several months or more. This study was undertaken to evaluate the immediate and midterm outcomes of vascu...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/s0741-5214(95)70268-7
更新日期：1995-02-01 00:00:00
abstract：:Endovascular repair is a valid alternative for patients with abdominal aortic aneurysms. However, in patients with concomitant aortocaval fistulas, type II endoleaks may result in a persistent communication between the aneurysm sac and the inferior vena cava. In these patients, prompt closure of the persistent fistula...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2012.10.138
更新日期：2013-10-01 00:00:00
abstract：OBJECTIVE:This study examined the outcomes of our novel concept of expanded provisional extension to induce complete attachment strategy (Petticoat) for safety, durability, and remodeling of chronic type B dissections. METHODS:Twenty patients with chronic type B aortic dissection with aneurysmal degeneration qualified...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2019.01.073
更新日期：2019-12-01 00:00:00
abstract：PURPOSE:Foot venous pressure measurement is considered to be useful for assessing lower limb venous insufficiency, because venous hypertension is the main factor predisposing to venous insufficiency. In this study, we investigated the utility of foot venous pressure measurement in the evaluation of venous insufficiency...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/s0741-5214(98)70232-0
更新日期：1998-04-01 00:00:00
abstract：:Eighteen patients whose mean age was 61 years were referred to us with acute aortic occlusion from 1977 to 1985. Ten patients had cardiac emboli (group I) and eight had aortoiliac occlusive disease (group II). Fourteen of these patients had paresis or paralysis. Diagnosis was prompt but the time lapse from onset of sy...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：
更新日期：1986-09-01 00:00:00
abstract：:Chronic venous insufficiency is a frequent sequel to lower extremity venous thrombosis. A relatively uncommon, but potentially lethal, cause of the thrombosis is congenital antithrombin III deficiency. Recognition and treatment of this occult deficiency is critical. The following report describes a family treated by t...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1067/mva.1990.17918
更新日期：1990-04-01 00:00:00
abstract：OBJECTIVE:The objective of this study was to define a normal range of distal graft velocity (DGV) and peak systolic velocity (PSV) on the basis of outflow level and maximum graft diameter for infrainguinal reversed vein bypass grafting (RVG). METHODS:This study was designed as a prospective study of consecutive patien...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/s0741-5214(99)70172-2
更新日期：1999-07-01 00:00:00
abstract：OBJECTIVE:This study was conducted to investigate factors influencing the outcome of all open operations for aortoiliofemoral (AIF) revascularization performed by a single surgeon at a tertiary referral center. METHODS:The series included 355 direct reconstructions and 181 extra-anatomic bypass (EAB) grafts in 339 men...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2006.09.065
更新日期：2007-03-01 00:00:00
abstract：PURPOSE:Neointimal hyperplasia frequently develops after placement of prosthetic vascular grafts and is a major cause of graft failure. This study was an attempt to prevent vascular lesion formation by coating the graft luminal surface with a thin layer of nonporous silicone polymer, and subsequently with an ultrathin ...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/s0741-5214(96)70019-8
更新日期：1996-11-01 00:00:00
abstract：:The lack of a rapid, noninvasive, and accurate method to confirm or rule out prosthetic graft infection continues to constitute a compelling and vexing clinical problem. A host of adjunctive diagnostic techniques has been used in the past, but early promising results subsequently have usually not yielded acceptable se...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1067/mva.1986.avs0030042
更新日期：1986-01-01 00:00:00
abstract：:Volume flow rates were measured in 31 expanded polytetrafluoroethylene grafts (6 mm) of 26 patients undergoing hemodialysis. Flow was calculated from the known access graft diameter and by measurement of the mean Doppler shift frequency waveform. Overall flow rates were 750 +/- 383 ml/min (range, 0 to 1921 ml/min). Th...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：
更新日期：1986-04-01 00:00:00
abstract：:Aneurysms of the infrapopliteal arteries are rare and commonly associated with trauma. Most appear as false aneurysms. Because they are quite rare events, we describe for the first time in the English-language literature two cases of a combination of true aneurysms of the popliteal and tibial arteries. Symptoms at ini...
journal_title：Journal of vascular surgery
pub_type： 杂志文章,评审
doi：10.1016/s0741-5214(96)70104-0
更新日期：1996-08-01 00:00:00
abstract：BACKGROUND:The Centers for Medicare and Medicaid Services (CMS) have established guidelines that outline patients who are considered "high risk" for complications after carotid endarterectomy (CEA) for which carotid artery stenting (CAS) may provide benefit. The validity of these high-risk criteria are yet unproven. In...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2012.12.075
更新日期：2013-07-01 00:00:00
abstract：:A knitted Dacron velour externally supported prosthesis was broken in two pieces at the supported portion 3 years after femoroposterior tibial bypass grafting. This type of graft problem has never been reported. Details of the clinical course, angiogram, CT scan, and scanning electron micrograph of a portion of the gr...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1067/mva.1990.19861
更新日期：1990-07-01 00:00:00
abstract：:The endothelial injury induced by the placement of a synthetic graft has been implicated as a stimulus for the development of MIH. In this study we compared the degree of EC coverage and the early SMC-PR in the arterial segments proximal and distal to 2 mm diameter PTFE grafts that had been placed in rabbit carotid ar...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1067/mva.1987.avs0050389
更新日期：1987-02-01 00:00:00
abstract：PURPOSE:This is a review of 100 consecutive supraaortic trunk reconstructions (SAT) performed over 16 years. METHODS:There were eight innominate endarterectomies and 92 bypass procedures based on the thoracic aorta (n = 86) or proximal innominate artery (n = 6) in 98 patients 24 to 79 years of age. Indications include...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/s0741-5214(98)70289-7
更新日期：1998-01-01 00:00:00
abstract：OBJECTIVE:The purpose of this study was to determine the clinical outcome of patients undergoing catheter-directed thrombolysis (CDT) for lower extremity arterial bypass (LEAB) occlusion. METHODS:A retrospective review was performed of two university-based practices from 1988 to 2001. All patients with LEAB occlusion ...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1067/mva.2003.42
更新日期：2003-01-01 00:00:00
abstract：PURPOSE:Although routine noninvasive surveillance is recommended after carotid endarterectomy (CEA), there are little data to show that identification and eradication of recurrent carotid artery stenosis are necessary to avoid the risk of subsequent neurologic complications. METHODS:We reviewed our experience over a 1...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：
更新日期：1993-05-01 00:00:00
abstract：:In a subset of patients requiring lower extremity revascularization, the popliteal artery may be used for inflow, thereby minimizing dissection and the length of vein required for bypass. This retrospective study was done to define the risks and benefits of arterial reconstruction in a population of patients having po...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1067/mva.1992.36607
更新日期：1992-05-01 00:00:00
abstract：PURPOSE:We tested the hypothesis that the course of primary chronic venous insufficiency can be changed by correction of the incompetent valve in the superficial femoral vein. METHODS:This was a prospective, randomized, controlled study. A total of 125 extremities with reflux in greater saphenous and superficial femor...
journal_title：Journal of vascular surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1067/mva.2001.110511
更新日期：2001-02-01 00:00:00
abstract：:Endovascular infections after percutaneous transluminal renal angioplasty with stenting (PTRAS) are rarely reported. Because strict longitudinal follow-up of patients undergoing PTRAS is lacking, the true incidence of such complications remains obscure. We report the first case of a patient with an infected renal arte...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/s0741-5214(98)70170-3
更新日期：1998-08-01 00:00:00
abstract：OBJECTIVE:Successful adaptation of a vein graft to an arterial environment is incompletely understood. We sought to investigate whether early vein graft remodeling is predictive of subsequent patency. METHODS:A prospective longitudinal study was conducted of 67 patients undergoing lower extremity bypass with autogenou...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2012.06.098
更新日期：2013-01-01 00:00:00
abstract：:This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy. ...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2010.04.054
更新日期：2010-07-10 00:00:00
abstract：INTRODUCTION:Successful endovascular exclusion of abdominal aortic aneurysms is largely dependent on adequate apposition of the stent graft to the aortic wall. Proximal endoleaks at the time of stent graft placement are uncommon but are more prevalent in patients with challenging neck anatomy. If these initial leaks do...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2010.11.095
更新日期：2011-05-01 00:00:00
abstract：:Paper-based information systems are cumbersome and inefficient. The microcomputer is an attractive, affordable, and powerful alternative to traditional paper-based record keeping. This article reviews fundamentals of data base management and microcomputer technology for the surgeon interested in microcomputer-based in...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1067/mva.1984.avs0010585
更新日期：1984-07-01 00:00:00
abstract：BACKGROUND:High failure rates of femoropopliteal artery (FPA) interventions are often attributed in part to severe mechanical deformations that occur with limb movement. Axial compression and bending of the FPA likely play significant roles in FPA disease development and reconstruction failure, but these deformations a...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2017.01.071
更新日期：2018-02-01 00:00:00
abstract：:We reviewed the results, systemic effects, and complications associated with the selective infusion of low-dose streptokinase in 151 patients. Successful thrombus lysis was achieved in 78% of atherosclerotic thrombotic occlusions less than 30 days old, in 81% of post-procedural occlusions less than 14 days old, and in...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1067/mva.1985.avs0020406
更新日期：1985-05-01 00:00:00
