The Pre-dilatation of vessels: A simple method to recruit small caliber veins for creating distal fistulas.

The Pre-dilatation of vessels: A simple method to recruit small caliber veins for creating distal fistulas. J Vasc Access. 2021 Jan 22;:1129729820983170 Authors: Napoli M, Zito A, Lefons ML, Ria P, Ferramosca E, Martella V, Caterina CM, Sozzo E, De Pascalis A Abstract Maturation failure remains a major clinical problem of distal arteriovenous fistula (AVF). Early failure (EF) is associated with the small size of the veins. For about 10 years we have used in more than 1000 fistulas, the Vessels Pre-Dilatation (VPD) to increase the recruitment of small veins for creating distal AVFs. The purpose of this study is to highlight if the VPD can reduce the incidence of EF or failure to mature (FTM) in AVFs created with small veins. Data of all the consecutive patients directly admitted to our Department for their first distal AVF from January to December 2019 were collected. The patients were divided in two groups, one with a vein diameter after the tourniquet ⩽2.0 mm (G1) and one >2 mm (G2). Both in G1 then in G2 the vessels had undergone VPD. Immediate failure (IF), EF, FTM, delayed or arrested maturation rate (DAM), unassisted AVFs and matured AFVs were evaluated. The patients recruited totalled 104, 37 in G1, and 67 in G2. The two groups were homogeneous in age, incidence of diabetes, obesity, heart disease, peripheral vasculopathy, and race. Female were more numerous in G1 (51% vs 12%, p < 0.001). In G1 and G2 occurred...
Source: The Journal of Vascular Access - Category: Surgery Tags: J Vasc Access Source Type: research