METHODS: A 66-year-old patient was scheduled for arterio-arterial graft implantation following failure of multiple previous vascular accesses. An 8 mm ringed PTFE graft was implanted in loop fashion subcutaneously in left anterior chest wall and anastomosed to transected ends of the axillary artery. Post-operative period was unremarkable and the graft was used for hemodialysis successfully for a period of 8 months.
UNASSIGNED: Arterio-arterial grafts can provide a flow rate up to 400 ml per minute for hemodialysis. Although the risk of steal syndrome is minimal in this form of vascular access, but the risk of limb ischemia following graft thrombosis should be considered.
CONCLUSIONS: Arterio-arterial grafts may be the only available option for continued hemodialysis in some patients and any vascular surgeon should be familiar with this type of vascular access.
方法:一名66岁的患者在先前多次血管通路失败后,计划进行动脉-动脉移植物植入。将8mm环状PTFE移植物以环状方式皮下植入左前胸壁,并吻合到腋下动脉的横切端。术后时间不明显,移植物成功用于血液透析,为期8个月。
■动脉-动脉移植物可以为血液透析提供高达400毫升/分钟的流速。尽管在这种血管通路中,盗血综合征的风险很小,但应考虑移植物血栓形成后肢体缺血的风险.
结论:在某些患者中,动脉-动脉移植物可能是唯一可用于持续血液透析的选择,任何血管外科医生都应该熟悉这种类型的血管通路。