Norton de Matos António, Sousa Clemente Neves, Almeida Paulo, Teles Paulo, Rego Duarte, Teixeira Gabriela, Loureiro Luís, Teixeira Sérgio
Vascular Access Center (Grupo de Estudos Vasculares), Porto, Portugal.
Angiology and Vascular Surgery Department, Centro Hospitalar do Porto, Porto, Portugal.
Hemodial Int. 2018 Oct;22(4):E53-E56. doi: 10.1111/hdi.12641. Epub 2018 Feb 20.
Dysfunction of arteriovenous access for hemodialysis is a challenge for the vascular surgeon. Some patients have complex vascular access with problems that are difficult to solve. Careful analysis of the vascular network with ultrasound and dissection of the veins during surgery can help to identify the best option for each access. We introduce and discuss the case of creation of a radio-cephalic fistula with outflow into the brachial vein in 64-year-old hemodialysis male patient. This technique enables extending fistula patency, arterializing the brachial vein, and improves cost efficiency.
血液透析动静脉通路功能障碍对血管外科医生来说是一项挑战。一些患者的血管通路复杂，存在难以解决的问题。手术中通过超声仔细分析血管网络并解剖静脉，有助于为每个通路确定最佳方案。我们介绍并讨论了一例64岁男性血液透析患者建立头静脉-桡动脉内瘘并将流出道引至肱静脉的病例。该技术能够延长内瘘通畅时间，使肱静脉动脉化，并提高成本效益。
