Pantea S, Jiga L, Ionac M, Lazar F
Second Surgery Department, V.Babes University of Medicine and Pharmacy, Timisoara, Romania.
Chirurgia (Bucur). 2013 Jul-Aug;108(4):563-7.
Vascular access in haemodialysis is still accompanied by a high morbidity rate. Neointimal hyperplasia due to thrombosis is one of the main causes of vascular access failure. The purpose of this paper is to present the use of non-penetrating titanium clips (VCS) for the creation of an arteriovenous fistula and its outcome.
A male patient, 47 years old, with end-stage renal disease - ESRD - (2005) was addressed to our service, for a vascular access reintervention, after a failed forearm radio-cephalic fistula performed 3 months before. In January 2007, an arteriovenous fistula between the brachial artery and the median cubital vein using non-penetrating titanium clips (Anastoclip VCS) was created.
The vascular anastomosis was performed in 17 min. After unclamping the artery, a solid pulse and consistent thrill were obtained at the level of the cubital fossa. The postoperative course was uneventful. The arteriovenous fistula remains functional 60 months post-surgery.
The Anastoclip VCS system is versatile, safe to manipulate and enables fast anastomosis. Arteriovenous anastomosis performed with non-penetrating clips may be a solution with the potential to reduce postoperative complications and extend arteriovenous fistula patency in ESRD.
血液透析中的血管通路仍伴随着较高的发病率。血栓形成导致的内膜增生是血管通路失败的主要原因之一。本文的目的是介绍使用非穿透性钛夹（VCS）建立动静脉内瘘及其效果。
一名47岁的男性患者，患有终末期肾病（ESRD，2005年确诊），在3个月前前臂桡动脉-头静脉内瘘手术失败后，前来我院进行血管通路再次干预。2007年1月，使用非穿透性钛夹（吻合夹VCS）在肱动脉和肘正中静脉之间建立了动静脉内瘘。
血管吻合手术用时17分钟。松开动脉夹后，在肘窝处可触及坚实的脉搏和持续的震颤。术后过程顺利。动静脉内瘘在术后60个月仍保持功能。
吻合夹VCS系统用途广泛，操作安全，能够实现快速吻合。使用非穿透性夹子进行动静脉吻合可能是一种解决方案，有潜力减少终末期肾病患者术后并发症并延长动静脉内瘘的通畅时间。
