What is it about?
Arteriovenous fistula (AVF) surgery is associated with a high rate of failure. Does the technique were trained to use is the cause? Interestingly it appears to be the cause at least some patients. A slight but easy alteration of the technique is associated with a higher rate of success!! It is simple. Give it a try. It is easy and any trained operator can do it.
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Why is it important?
Since the first AVF was described in 1966 there has not been much technical innovation in this surgical procedure. People have tried to use the same technique in different sites with a similar failure rate. Author feels that lack of understanding of pathophysiological changes that drives the success of this procedure is the main reason behind the high failure rate. The higher success rate using the technical alteration underscores the importance of understanding the role of hemodynamics in the problems associated with AV access.
Perspectives
Understanding the hemodynamic changes which are inherent for this surgical procedure provides an opportunity to manipulate them as shown by the current technique and achieve a better outcome.
surendra shenoy
Washington University in Saint Louis
Read the Original
This page is a summary of: A novel technique of vascular anastomosis to prevent juxta-anastomotic stenosis following arteriovenous fistula creation, Journal of Vascular Surgery, January 2012, Elsevier,
DOI: 10.1016/j.jvs.2011.07.090.
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