Non-maturation of arteriovenous fistulas is a frequent problem after dialysis access creation, especially in the forearm. The presence of accessory veins may play an important role in the non-maturing fistula. Several surgical and endovascular techniques are described to deal with this problem. We describe a new surgical technique in which we perform a rejoining of the arm veins to create a single large run-off vessel with greater diameter and flow for haemodialysis.
TordoirJHMickleyV.European guidelines for vascular access: clinical algorithms on vascular access for haemodialysis. EDTNA ERCA J2003; 29(3): 131–136.
2.
AllonMRobbinML.Increasing arteriovenous fistulas in hemodialysis patients: problems and solutions. Kidney Int2002; 62(4): 1109–1124.
3.
PlankenRNLeinerTNijenhuisRJ, et al. Contrast-enhanced magnetic resonance angiography findings prior to hemodialysis vascular access creation: a prospective analysis. J Vasc Access2008; 9(4): 269–277.
4.
PlankenRNDuijmLEKesselsAG, et al. Accessory veins and radial-cephalic arteriovenous fistula non-maturation: a prospective analysis using contrast-enhanced magnetic resonance angiography. J Vasc Access2007; 8(4): 281–286.
5.
BeathardGAArnoldPJacksonJ, et al. Aggressive treatment of early fistula failure. Kidney Int2003; 64(4): 1487–1494.
6.
MillerGAGoelNKharitonA, et al. Aggressive approach to salvage non-maturing arteriovenous fistulae: a retrospective study with follow up. J Vasc Access2009; 10(3): 183–191.
7.
ChangCJKoPJHsuLA, et al. Highly increased cell proliferation activity in the restenotic hemodialysis vascular access after percutaneous transluminal angioplasty: implication in prevention of restenosis. Am J Kidney Dis2004; 43(1): 74–84.
8.
TordoirJZonnebeldNVan LoonMM, et al. Surgical and endovascular intervention for dialysis access maturation failure during and after arteriovenous fistula surgery: review of the evidence. Eur J Vasc Endovasc Surg2018; 55(2): 240–248.
9.
UrayamaHKatadaSMatsumotoI, et al. Reconstruction of jugular and portal blood flows using remodeled great saphenous vein grafts. Surg Today1993; 23: 936–938.
10.
AlomranFBouraBMalliosA, et al. Tagliatelle technique for arteriovenous fistula creation using a great saphenous vein semipanel graft. J Vasc Surg2013; 58(6): 1705–1708.