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MINERVA UROLOGICA E NEFROLOGICA
A Journal on Nephrology and Urology
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,536
Minerva Urologica e Nefrologica 1999 December;51(4):211-5
Artero/venous fistulas for hemodialysis: personal experience with transposed cephalic vein
Chiti E. 1, Ercolini L. 1, Mancini G. 2, Terreni A. 1, Dorigo W. 1, Bandini S. 2, Pratesi C. 1, Salvadori M. 2
1 Università degli Studi - Firenze, U. O. e Cattedra di Chirurgia Vascolare
2 Azienda Ospedaliera Careggi - Firenze, U. O. di Nefrologia, Dialisi e Trapianto
Background. Vascular access for hemodialysis has remarkably developed during these years. Since 1966 we have the Brescia-Cimino fistula which is considered nowadays the best choice for angioaccess. The transposed cephalic vein is the “variant” which has been evaluated in a single stage surgical technique.
Methods. A prospective and randomized study regarding 23 patients submitted to operation for first fistula during 1998. With a median follow-up of 10 months, these fistulas have been studied with echocolordoppler in order to verify their primary patency, diameter and blood flow in artery, in vein and anastomosis.
Results. Fistulas have been patented in all cases (15 males e 8 females) and used for dialysis after 3 weeks. No early or late complications have been observed. Mean diameter has been 1.2 cm with mean velocity of 1.8 m/sec, in artery mean velocity 2.3 m/sec and in vein 1.1 m/sec.
Conclusions. Increasing length of life even for high critical patients like these with chronic renal failure underlines the need of surgical strategies which may improve the quality to life. This technique of transposed cephalic vein has the same advantages of direct fistulas also for those patients in which we should have used prosthetic grafts.