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"All surgical methods published to date for the reduction of excessive high-flow in native elbow fistulas for dialysis have limitations. We report a new surgical approach to flow reduction by transposition of the radial artery to the elbow level," researchers in Paris, France report (see also Angiology).
"From 1992 to 2008, 47 consecutive patients (22 women) with brachial artery to elbow vein autogenous fistula underwent flow reduction via replacement of brachial artery by transposed distal radial artery inflow. Fistulas were side-to-end either brachial-cephalic (19) or brachial-basilic (28). The indications were hand ischemia (4), cardiac failure (13), concerns about future cardiac dysfunction (23), and chronic venous hyertension resulting in aneurysmal. p degeneration of the vein (7). Mean patient age was 44 years, 11% were diabetic, 17% were smokers, and mean BMI was 22. Mean fistula age before flow reduction was 2.5 years. Technical success was 91% (43 of 47). The mean flow rate dropped by 66% +/- 14%. Clinical success in symptomatic patients was 75% (18 of 24). The fistula eventually had to be ligated in three cases of cardiac failure because of insufficient clinical improvement. All four patients with hand ischemia were cured, with no recurrence during ...
Source: HighBeam Research, New angiology study results from P. Bourquelot et al described.