Takashima Tsuyoshi, Nonaka Yasunori, Nakashima Yui, Nonaka Eriko, Matsumoto Keiichiro, Fukuda Makoto, Rikitake Shuichi, Miyazono Motoaki, Rikitake Kazuhisa, Ikeda Yuji
Department of Nephrology, National Hospital Organization, Ureshino Medical Center, Ureshino, Saga, Japan.
Department of Nephrology, National Hospital Organization, Ureshino Medical Center, Ureshino, Saga, Japan.
Ann Vasc Surg. 2019 Nov;61:466.e7-466.e11. doi: 10.1016/j.avsg.2019.04.033. Epub 2019 Jul 23.
A radiocephalic arteriovenous fistula (AVF) in the anatomical snuffbox is the most distal site of AVF in the upper limb. When the cephalic vein distal to the wrist is in poor condition or thrombosed, creating the typical radiocephalic AVF in the distal forearm just proximal to the wrist will likely be considered. However, we have adopted an operative technique for creating a transposed radial artery-dorsal metacarpal vein AVF (RDAVF) in the anatomical snuffbox when possible in such cases. RDAVF is AVF using the most peripheral autologous vein in the upper limb. To our knowledge, the creation of an RDAVF has not been previously reported. We herein describe the steps of the technique and report the successful treatment of a hemodialysis patient who developed occlusion of a radiocephalic AVF in the anatomical snuffbox.
位于解剖学鼻烟壶处的桡动脉-头静脉动静脉内瘘（AVF）是上肢AVF最远端的部位。当腕部远端的头静脉状况不佳或发生血栓形成时，可能会考虑在腕部近端的前臂远端创建典型的桡动脉-头静脉AVF。然而，在这种情况下，我们尽可能采用一种手术技术，在解剖学鼻烟壶处创建转位桡动脉-手背静脉动静脉内瘘（RDAVF）。RDAVF是使用上肢最外周自体静脉的AVF。据我们所知，此前尚未有关于创建RDAVF的报道。我们在此描述该技术步骤，并报告一例在解剖学鼻烟壶处桡动脉-头静脉AVF发生闭塞的血液透析患者的成功治疗情况。
