Side-to-side arteriovenous fistula at the elbow with perforating vein ligation

Majid Moini, G. Melville Williams, Mohammad Sadegh Pourabbasi, Mohammad Reza Rasouli, Payam Tarighi, Armita Mardanloo, Hussein Rayatzadeh

Research output: Contribution to journalArticle

Abstract

Objective: We postulated that ligation of a consistent perforating venous branch at the elbow would improve distention and flow in the superficial veins about the elbow. This would also lesson the likelihood of arterial steal enabling a favorable outcome following a brachial artery medial antecubital or cephalic vein arterio-venous fistula (AVF). Methods: Pressure measurements were made from the radial artery after side-to-side brachial artery antecubital or cephalic vein AVF in 20 patients. Clamping of the perforating vein increased radial artery pressure significantly indicating that a considerable amount of flow from the side-to-side AVF was diverted into the deep system and away from the accessible superficial veins. Encouraged by this finding, we studied the outcome of brachial cephalic or brachial antecubital AVF with ligation of the deep branch in 134 patients who were not candidates for radio-cephalic AVF. The end point of the study was successful hemodialysis using the fistula. Results: Of the 134 patients treated, 24 died, and 11 were lost to follow-up and were censored from analysis of fistula performance at that time point. The primary fistula success rate was 89.7% ± 2.66% and 83.7% ± 3.5% at 1 and 2 years by life table analysis. No patient developed significant arterial steal or venous hypertension. Conclusion: We recommend this simple one-stage procedure for patients requiring hemodialysis whose cephalic vein at the wrist is unsuitable.

Original languageEnglish (US)
Pages (from-to)1274-1278
Number of pages5
JournalJournal of Vascular Surgery
Volume47
Issue number6
DOIs
StatePublished - Jun 2008

Fingerprint

Arteriovenous Fistula
Elbow
Fistula
Ligation
Veins
Head
Radial Artery
Brachial Artery
Renal Dialysis
Arm
Pressure
Life Tables
Lost to Follow-Up
Wrist
Radio
Constriction
Hypertension

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Moini, M., Williams, G. M., Pourabbasi, M. S., Rasouli, M. R., Tarighi, P., Mardanloo, A., & Rayatzadeh, H. (2008). Side-to-side arteriovenous fistula at the elbow with perforating vein ligation. Journal of Vascular Surgery, 47(6), 1274-1278. https://doi.org/10.1016/j.jvs.2007.11.075

Side-to-side arteriovenous fistula at the elbow with perforating vein ligation. / Moini, Majid; Williams, G. Melville; Pourabbasi, Mohammad Sadegh; Rasouli, Mohammad Reza; Tarighi, Payam; Mardanloo, Armita; Rayatzadeh, Hussein.

In: Journal of Vascular Surgery, Vol. 47, No. 6, 06.2008, p. 1274-1278.

Research output: Contribution to journalArticle

Moini, M, Williams, GM, Pourabbasi, MS, Rasouli, MR, Tarighi, P, Mardanloo, A & Rayatzadeh, H 2008, 'Side-to-side arteriovenous fistula at the elbow with perforating vein ligation', Journal of Vascular Surgery, vol. 47, no. 6, pp. 1274-1278. https://doi.org/10.1016/j.jvs.2007.11.075
Moini M, Williams GM, Pourabbasi MS, Rasouli MR, Tarighi P, Mardanloo A et al. Side-to-side arteriovenous fistula at the elbow with perforating vein ligation. Journal of Vascular Surgery. 2008 Jun;47(6):1274-1278. https://doi.org/10.1016/j.jvs.2007.11.075
Moini, Majid ; Williams, G. Melville ; Pourabbasi, Mohammad Sadegh ; Rasouli, Mohammad Reza ; Tarighi, Payam ; Mardanloo, Armita ; Rayatzadeh, Hussein. / Side-to-side arteriovenous fistula at the elbow with perforating vein ligation. In: Journal of Vascular Surgery. 2008 ; Vol. 47, No. 6. pp. 1274-1278.
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