RESUMO
The distal arteriovenous fistula (AVF) has less complications and better patency than the proximal fistula, when it works properly. The complications of outflow of the fistula are complex, and it is necessary to analyze all solutions to solve the problem. We introduce a novel approach to solve outflow problems of a radio-cephalic AVF by straightening of the forearm cephalic vein with drainage into the median basilic vein.
Assuntos
Fístula Arteriovenosa , Derivação Arteriovenosa Cirúrgica , Humanos , Antebraço/irrigação sanguínea , Antebraço/cirurgia , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Grau de Desobstrução Vascular , Diálise Renal , Veias/diagnóstico por imagem , Veias/cirurgia , Drenagem , Resultado do TratamentoRESUMO
The vascular access is the mainstay of hemodialysis. Arteriovenous fistula has been prioritized as the first choice of long-term vascular access for its inferior rate of complications and improved patient survival. Rope ladder and buttonhole venipuncture are the most common techniques for arteriovenous fistulae cannulation. Much of the concern regarding buttonhole cannulation is the increased risk for potentially severe systemic infections. Increased risk for stenosis and thrombosis has been addressed but not confirmed. We discuss two cases of stenosis and thrombosis related to buttonhole puncture which heralded angiography intervention, raising awareness for the demand of close surveillance of arteriovenous fistulae when using buttonhole cannulation.
Assuntos
Fístula Arteriovenosa/etiologia , Derivação Arteriovenosa Cirúrgica/métodos , Cateterismo/efeitos adversos , Constrição Patológica/etiologia , Diálise Renal/métodos , Trombose/etiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , HumanosRESUMO
This paper presents the concept and most of the research undertaken all over the world for the development of a bio-artificial pancreas (BAP) device over the last 30 years. The devices studied, meant to mimic the insulin secretion of the natural organ, were diverse and have been reviewed. Allogeneic or xenogeneic cells or cell clusters have been separated from the host's immune system by synthetic biocompatible semipermeable membranes to prevent the need, of the host, for immune-suppressing regimens. The biocompatible polymer used as a barrier and its intrinsic characteristics, the cell immobilization or suspension media, the existence or not of co-immobilized molecules or cells, the number of devices used and the implantation site, were addressed.
