Rafizadeh Andre, Lee Thomas, James Kevin, Wernick Brian
Department of Surgery, Morristown Medical Center, Morristown, NJ.
J Vasc Surg Cases Innov Tech. 2022 Nov 17;9(1):101051. doi: 10.1016/j.jvscit.2022.10.009. eCollection 2023 Mar.
In the setting of ischemic steal syndrome with tissue loss, patients with radiocephalic fistulas have limited options to preserve their conduit and treat their ischemic symptoms. To address this, we have proposed the technique of proximalization through one incision of a wrist arteriovenous fistula (POWR) with distal revascularization with interval ligation (DRIL) procedure. In the present retrospective, single-center, case series, we evaluated the outcomes of three patients with radiocephalic fistulas who had undergone POWR DRIL from 2017 to 2021. Their ischemic symptoms were monitored for regression. All three patients showed signs of regressing ischemia. The POWR DRIL represents an efficient procedure to address tissue loss and preserve the autogenous conduit.
在伴有组织缺失的缺血性窃血综合征情况下，头静脉桡动脉内瘘患者在保留其血管通路并治疗缺血症状方面选择有限。为解决这一问题，我们提出了通过腕部动静脉内瘘单切口近端化（POWR）联合间隔结扎远端血管重建（DRIL）手术的技术。在本项回顾性、单中心病例系列研究中，我们评估了2017年至2021年间接受POWR DRIL手术的3名头静脉桡动脉内瘘患者的治疗效果。监测他们的缺血症状是否缓解。所有3例患者均出现缺血缓解迹象。POWR DRIL是一种解决组织缺失并保留自体血管通路的有效手术。
