Abstract
Three hundred and eighty children underwent 434 angioaccesses. Of these angioaccesses, 113 were constructed in 74 children weighing under 10 kg. Most accesses (n=340) were distal arteriovenous fistulae (AVF). After microsurgery there was a 96% immediate patency. Seventy percent of AVF, excluding distal ulnarbasilic AVF, were functional, sometimes after secondary superficialization of the vein. Eighty-five per cent of the distal radial-cephalic AVF are still patent after 2 years, 60% are still patent after 4 years. These radial-cephalic AVF required 65 repeat anastomoses, and 12 ligations of the proximal-radial artery in order to reduce to 50% the high blood flow (pre-reduction average index = 900 ml/min per m2). The patency rate of arteriovenousbridge grafts was not encouraging. The severity of stenoses in the proximal-venous trunks, sometimes related to previous catheterization, is emphasized. Advantages of the radial-cephalic wrist AVF in children are highlighted.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Brescia MJ, Cimino JE, Appel K, Hurwich BG (1966) Chronic hemodialysis using venipuncture and a surgically created arteriovenous fistula. N Engl J Med 275: 1089–1091
Broyer M, Loirat C, Gagnadoux MF, Cukier J, Beurton D, Vacant J (1973) “By-pass” et fistule arterio-veineuse en vue de l'hémodialyse chronique chez l'enfant. Arch Fr Pediatr 30: 145–161
Gagnadoux MF, Degoulet P, Pascal B, Bourquelot P, Kermarc'h C, Lauwers E, Loirat C, Broyer M (1978) L'abord vasculaire chez l'enfant traité par hémodialyse périodique. Nephrologie 12: 935–944
Sicard G, Merrell R, Etheredge E, Anderson C (1978) Subcutaneous arteriovenous dialysis fistulas in pediatric patients. Trans Am Soc Artif Intern Organs 24: 695–698
Coulonges S (1978) Abords vasculaires pour hémodialyse chronique chez 23 enfants apport de la microchirurgie. Medical Thesis, Paris VI, Université Pierre et Marie Curie
Bourquelot P, Wolfeler L, Lamy L (1981) Microsurgery for haemodialysis distal arteriovenous fistulae in children weighing less than 10 kg. Proc Eur Dial Transplant Assoc 18: 537–540
Kinnaert P, Janssen F, Hall M (1983) Elbow arteriovenous fistula (EAVF) for chronic hemodialysis in small children. J Pediatr Surg 18: 116–119
So S (1984) Venous access for hemodialysis in children; right atrial cannulation. In: Simmons RL, Finch ME, Ascher NL, Najarian JS (eds) Manual of vascular access, organ donation and transplantation. Springer, New York Berlin Heidelberg, p 27–36
Yazbeck S, O'Regan S (1984) Microsurgery for Brescia-Cimino fistula construction in pediatric patients. Nephron 38: 209–212
Bourquelot P, Cussenot O, Fournier F (1986) Création microchirurgicale des fistules artério-veineuses pour hémodialyse chronique chez l'enfant de moins de 10 kg. Chirurgie 112: 681–685
Levy B, Bourquelot P, Ponsin JC, Man NK, Martineaud P (1984) Noninvasive and invasive blood flowmetry in hemodialyzed patients with high blood flow fistulas. Trans Am Soc Artif Intern Organs 30: 335–337
Bourquelot P, Corbi P, Cussenot O (1989) Surgical improvement of high-flow arteriovenous fistulas. In: Sommer BG, Henry ML (eds) Vascular access for hemodialysis. Gore and Pluribus, USA pp 124–130
Pillion G, Bourquelot P, Macher MC, Broux F, Maisin A, Loirat C (1988) Abords vasculaires chez les enfants de moins de 10 kg. In: Morinière P, Pourchez T (eds) Les abords vasculaires pour épuration extra-rénale. Comptes rendus du congrès national d'Amiens. Masson, Paris, pp 60–65
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Bourquelot, P., Cussenot, O., Corbi, P. et al. Microsurgical creation and follow-up of arteriovenous fistulae for chronic haemodialysis in children. Pediatr Nephrol 4, 156–159 (1990). https://doi.org/10.1007/BF00858828
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00858828