FIVE CASES OF ARTERIAL RECONSTRUCTION FOR COMPLICATIONS OF ARTERIOVENOUS FISTULA IN CHRONIC MAINTENANCE HEMODIALYSIS

During the past five years, arterial reconstruction was performed in five cases of chronic maintenance hemodialysis for complications of arteriovenous fistula. The subjects were three males and two females. The cases of arteriovenous fistula with complications involved three cases of arteriovenous fistula between the cutaneous veins proximal to the brachial artery, one case of gore-tex graft arteriovenous fistula between the brachial artery and vein and one case of bovine graft arteriovenous fistula between the femoral artery and vein. The complicatons for which arterial reconstruction was necessary involved four cases of intrafistular infection and one case of acute arterial embolism. In the four cases of infection, autoplasty of the venous bypass was performed, bypassing the involvement and passing under the medial skin at the elbow joint area. This course was considered to be appropriate because the graft was not bent by movement of the joint. In the one case of arterial embolism, embolectomy was performed with a Fogarty catheter. The most troublesome complication was that of infection, and much care must be taken to prevent infection in arteriovenous fistulation or intrafistular puncture.