Staged Superficialization of Deep Arm Autogenous Brachio-Cephalic Arterio-Venous Fistula Via Duplex Guided Liposuction: Feasibility and Outcome
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- Category: Vol. 85, March 2017
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Staged Superficialization of Deep Arm Autogenous Brachio-Cephalic Arterio-Venous Fistula Via Duplex Guided Liposuction: Feasibility and Outcome, KHALED EL-ALFY, HOSAM ROSHDY, SAMER REGAL, AHMED EL-METWALY, AHMED A.M. KHALIL, ESAM ABOU BEIH and KHALED EL-DAHSHAAN
Abstract
Background: An easy cannulable vascular access is of paramount importance for patients on hemodialysis. Different options were utilized to make deep veins of functioning mature fistulae more superficial and amenable for easy cannulation. This study aims to evaluate duplex guided liposuction as a mean for superficialisation of deep arm cephalic vein.
Material and Methods: From January 2012 till June 2015, 21 patients with well-functioning, mature cephalic vein of proximal brachio-cephalic fistulae in the arm underwent duplex guided liposuction in order to make these accesses more superficial and easy for cannulation.
Results: There were 7 males (33.3%) and 14 females (66.7%) with age range between (28-62) years with a mean of (47±9.7) years and a mean BMI of 35.8±4.4. The vein had a mean depth of 17.9±2.7mm from the skin and its diameter increased from a mean of 6.4±0.2mm pre-intervention to a mean of 7.4±0.4mm post-intervention. Primary patency was 95.3% and 80.5% at 12 and 24 months respectively.
Conclusion: Staged liposuction of deep cephalic vein of a mature functioning arm brachio-cephalic fistula is safe and effective procedure yet multicenter trials should be conducted to further attain solid data regarding its long term results and compare it to other superficialisation modalities.