Arch Reconstr Microsurg.  2014 Nov;23(2):97-100. 10.15596/ARMS.2014.23.2.97.

Arteriovenous Fistula Formation Using Microscope Rather than Surgical Telescope

• Lee BH
• Suh IS
• Cho AJ
• Noh JW
• Jeong HS

• KMID: 1917847
• DOI: http://doi.org/10.15596/ARMS.2014.23.2.97

Abstract

The number of patients with chronic renal failure who require renal replacement therapy is increasing and dialysis is still the mainly used renal replacement therapy. The first choice of surgical technique currently used is side-to-end anastomosis of the radial artery and the cephalic vein. The authors report on a case of an effective arteriovenous shunt operation performed using microscopy. A 53-year-old male with chronic renal failure was referred to plastic and reconstructive surgery department to undergo an arteriovenous shunt operation. Venography was performed before surgery in order to find the appropriate vessel for the arteriovenous shunt operation. The cephalic vein on the wrist showed a diameter of over 4 mm, which was appropriate for an arteriovenous shunt operation. Anastomosis of the vessels was performed under microscopy using Nylon #9-0. Blood flow and vessel diameter were evaluated by venography after surgery and showed well maintained function of the shunt. Complications such as bleeding, edema of the upper arm, and wound dehiscence did not occur. Many factors and certain complications may affect the long-term patency of an arteriovenous shunt; however, exquisite surgical technique is the most important factor in a successful operation. Thus, arteriovenous shunt operation using microscopy is thought to be a good treatment option.

Keyword

Chronic renal failure; Arteriovenous fistula; Shunt; Microscopy

MeSH Terms

Arm
Arteriovenous Fistula*
Dialysis
Edema
Hemorrhage
Humans
Kidney Failure, Chronic
Male
Microscopy
Middle Aged
Nylons
Phlebography
Plastics
Radial Artery
Renal Replacement Therapy
Telescopes*
Veins
Wounds and Injuries
Wrist
Nylons
Plastics