Ali Aamna Mahnoor, Khan Sadia, Tayyarah Majid
General Surgery, Kaiser Permanente-Arrowhead Regional Medical Center, Fontana, CA.
Breast and Oncologic Surgery, Department of Surgery, University of Southern California, Los Angeles, CA.
Ann Vasc Surg. 2016 Apr;32:128.e15-7. doi: 10.1016/j.avsg.2015.10.013. Epub 2016 Jan 21.
Native arteriovenous fistula (AVF) placement in patients with ipsilateral mastectomy and radiation has been avoided because of concerns regarding central venous outflow obstruction. To our knowledge, only 3 such cases have been reported. We present a patient with bilateral mastectomies and right-sided radiation therapy presenting for vascular access in the setting of multiple failed AVF in her left upper extremity and infected-groin catheter, central catheters, and axillary loop graft. We created and superficialized a radiocephalic AVF in her right upper extremity in the setting of central vein occlusion and robust collaterals which remains patent and has been cannulated successfully.
由于担心中心静脉流出道梗阻，同侧乳房切除术和放疗患者一直避免进行自体动静脉内瘘（AVF）置入。据我们所知，仅报道过3例此类病例。我们报告了一名接受双侧乳房切除术和右侧放疗的患者，其左上肢多次AVF失败，腹股沟导管、中心静脉导管及腋部袢式移植物感染，现需要血管通路。在中心静脉闭塞且有丰富侧支循环的情况下，我们在她的右上肢建立并浅表化了一个桡动脉-头静脉内瘘，该内瘘保持通畅且已成功穿刺。
