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Radial Artery Deviation and Reimplantation (RADAR) to Accelerate the Maturation of Radial-Cephalic Fistulas for Hemodialysis in Patients with End-Stage Renal Disease

Background: The most common form of vascular access for hemodialysis is a native arteriovenous fistula, which connects the site of the artery to the end of the vein. The maturation process of the fistula plays a crucial role in the establishment of a functional vascular access. Radial artery stenosi...

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Autores principales: Gołębiowski, Tomasz, Kusztal, Mariusz, Konieczny, Andrzej, Gołębiowski, Maciej, Letachowicz, Krzysztof, Janczak, Dariusz, Krajewska, Magdalena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10607320/
https://www.ncbi.nlm.nih.gov/pubmed/37892619
http://dx.doi.org/10.3390/jcm12206481
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author Gołębiowski, Tomasz
Kusztal, Mariusz
Konieczny, Andrzej
Gołębiowski, Maciej
Letachowicz, Krzysztof
Janczak, Dariusz
Krajewska, Magdalena
author_facet Gołębiowski, Tomasz
Kusztal, Mariusz
Konieczny, Andrzej
Gołębiowski, Maciej
Letachowicz, Krzysztof
Janczak, Dariusz
Krajewska, Magdalena
author_sort Gołębiowski, Tomasz
collection PubMed
description Background: The most common form of vascular access for hemodialysis is a native arteriovenous fistula, which connects the site of the artery to the end of the vein. The maturation process of the fistula plays a crucial role in the establishment of a functional vascular access. Radial artery stenosis is among the potential causes of maturation failure. In these cases, improving the fistula’s blood flow may be difficult, as traditional surgical reanastomosis and endovascular intervention frequently fail. Radial artery deviation and reimplantation (RADAR) is a novel and effective technique for creating primary fistulas with a high patency rate. The main disadvantage of this procedure is the ligation of the radial artery and the subsequent known consequences. Methods: To accelerate maturation, we used RADAR as a secondary approach in three patients with radial artery stenosis and maturation failure. Results: In all patients after surgery, we observed a significant increase in fistula blood flow. Two patients used fistulas for hemodialysis after surgery. We describe the image diagnosis, procedure, and benefits of this method. Conclusions: The RADAR technique may be successfully used as a secondary access in patients with maturation failure due to RA stenosis to accelerate fistula maturation.
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spelling pubmed-106073202023-10-28 Radial Artery Deviation and Reimplantation (RADAR) to Accelerate the Maturation of Radial-Cephalic Fistulas for Hemodialysis in Patients with End-Stage Renal Disease Gołębiowski, Tomasz Kusztal, Mariusz Konieczny, Andrzej Gołębiowski, Maciej Letachowicz, Krzysztof Janczak, Dariusz Krajewska, Magdalena J Clin Med Technical Note Background: The most common form of vascular access for hemodialysis is a native arteriovenous fistula, which connects the site of the artery to the end of the vein. The maturation process of the fistula plays a crucial role in the establishment of a functional vascular access. Radial artery stenosis is among the potential causes of maturation failure. In these cases, improving the fistula’s blood flow may be difficult, as traditional surgical reanastomosis and endovascular intervention frequently fail. Radial artery deviation and reimplantation (RADAR) is a novel and effective technique for creating primary fistulas with a high patency rate. The main disadvantage of this procedure is the ligation of the radial artery and the subsequent known consequences. Methods: To accelerate maturation, we used RADAR as a secondary approach in three patients with radial artery stenosis and maturation failure. Results: In all patients after surgery, we observed a significant increase in fistula blood flow. Two patients used fistulas for hemodialysis after surgery. We describe the image diagnosis, procedure, and benefits of this method. Conclusions: The RADAR technique may be successfully used as a secondary access in patients with maturation failure due to RA stenosis to accelerate fistula maturation. MDPI 2023-10-12 /pmc/articles/PMC10607320/ /pubmed/37892619 http://dx.doi.org/10.3390/jcm12206481 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Technical Note
Gołębiowski, Tomasz
Kusztal, Mariusz
Konieczny, Andrzej
Gołębiowski, Maciej
Letachowicz, Krzysztof
Janczak, Dariusz
Krajewska, Magdalena
Radial Artery Deviation and Reimplantation (RADAR) to Accelerate the Maturation of Radial-Cephalic Fistulas for Hemodialysis in Patients with End-Stage Renal Disease
title Radial Artery Deviation and Reimplantation (RADAR) to Accelerate the Maturation of Radial-Cephalic Fistulas for Hemodialysis in Patients with End-Stage Renal Disease
title_full Radial Artery Deviation and Reimplantation (RADAR) to Accelerate the Maturation of Radial-Cephalic Fistulas for Hemodialysis in Patients with End-Stage Renal Disease
title_fullStr Radial Artery Deviation and Reimplantation (RADAR) to Accelerate the Maturation of Radial-Cephalic Fistulas for Hemodialysis in Patients with End-Stage Renal Disease
title_full_unstemmed Radial Artery Deviation and Reimplantation (RADAR) to Accelerate the Maturation of Radial-Cephalic Fistulas for Hemodialysis in Patients with End-Stage Renal Disease
title_short Radial Artery Deviation and Reimplantation (RADAR) to Accelerate the Maturation of Radial-Cephalic Fistulas for Hemodialysis in Patients with End-Stage Renal Disease
title_sort radial artery deviation and reimplantation (radar) to accelerate the maturation of radial-cephalic fistulas for hemodialysis in patients with end-stage renal disease
topic Technical Note
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10607320/
https://www.ncbi.nlm.nih.gov/pubmed/37892619
http://dx.doi.org/10.3390/jcm12206481
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