Hatjibaloglou A, Grekas D, Saratzis N, Megalopoulos A, Moros I, Kiskinis D, Dalainas V
First Department of Surgery, University Hospital AHEPA, Thessaloniki, Greece.
Artif Organs. 1992 Dec;16(6):623-5. doi: 10.1111/j.1525-1594.1992.tb00561.x.
Twenty-five brachial-basilic arteriovenous (AV) fistulas with transposed basilic vein for alternative vascular access were created in 22 chronic hemodialysis patients. This surgical procedure was performed under brachial block or general anesthesia. After a longitudinal skin incision that was made in the inner side of the arm, the basilic vein was exposed, transposed subcutaneously, and anastomosed end-to-side to the brachial artery. The follow-up was between 7 and 24 months. Early complications were hemorrhage, thrombosis, steal syndrome, and swelling of the arm. Among the late complications were failure of the fistula because of thrombosis and multiple stenosis at the site of venipuncture. The accumulated one-year patency rate of fistulas was 81%. The complications of high-output cardiac failure or local infection were not seen in our study. On the basis of our results, the brachial-basilic AV fistula with transposed basilic vein is a useful and safe second- or third-choice vascular procedure for hemodialysis patients, in particular for women without good quality of vessels.
在22例慢性血液透析患者中创建了25个采用肱动脉-贵要静脉转位术建立的动静脉（AV）内瘘，作为备用血管通路。该手术在臂丛阻滞或全身麻醉下进行。在手臂内侧做一纵向皮肤切口后，暴露贵要静脉，将其皮下转位，并与肱动脉进行端侧吻合。随访时间为7至24个月。早期并发症包括出血、血栓形成、窃血综合征和手臂肿胀。晚期并发症包括因血栓形成导致的内瘘失功以及静脉穿刺部位的多处狭窄。内瘘的累积一年通畅率为81%。本研究中未观察到高输出量心力衰竭或局部感染等并发症。根据我们的研究结果，采用贵要静脉转位术的肱动脉-贵要静脉动静脉内瘘对于血液透析患者来说是一种有用且安全的第二或第三选择的血管手术，尤其适用于血管条件不佳的女性患者。
