Greene JB, Giangola G, Salik JM, Walsh I, Felice JA, Ratkewich M; International Conference on AIDS.
Int Conf AIDS. 1994 Aug 7-12; 10: 227 (abstract no. PB0922).
NYU Medical Center.
OBJECTIVE: Patients with advanced AIDS frequently require chronic vascular access for the administration of various antimicrobial agents. Subcutaneous port systems and percutaneous/tunnelled catheters have a high rate of infection, thrombosis, and catheter failure/migration. We sought to evaluate the utility of surgically created arterio-venous fistulae as a chronic vascular access alternative. METHODS: Because of multiple/recurrent Hickman catheter infections in two patients, and a chronic dermatosis predisposing to infection in a third patient, chronic vascular access was accomplished by the surgical creation of an upper extremity arterio-venous fistula. RESULTS: No surgical complications were observed and excellent venous arcades were ready for accessing within two weeks after surgery. Patients were taught to self-access their veins with small-bore butterfly needles and were successful in maintaining their therapies [ganciclovir (2), foscarnet (1)] without infection, fistula failure or other complications. Patient selection guidelines, clinical follow-up and comparative retrospective data from a national catheter registry will be presented. CONCLUSIONS: Surgical arterio-venous fistulae represent a potential alternative to indwelling catheters for chronic vascular access in selected patients with AIDS.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Arteriovenous Fistula
- Catheterization, Central Venous
- Catheters, Indwelling
- Communicable Diseases
- Humans
- Infection
- Physical Therapy Modalities
- Registries
- Treatment Outcome
Other ID:
UI: 102210387
From Meeting Abstracts