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Radial artery deviation and reimplantation inhibits venous juxta-anastomotic stenosis and increases primary patency of radial-cephalic fistulas for hemodialysis Nirvana Sadaghianloo, MD, Serge Declemy, MD, Elixène Jean-Baptiste, MD, PhD, Pierre Haudebourg, MD, Christophe Robino, MD, Mohamed Shariful Islam, MD, Réda Hassen-Khodja, MD, Alan Dardik, MD, PhD Journal of Vascular Surgery Volume 64, Issue 3, Pages e1 (September 2016) DOI: /j.jvs Copyright © 2016 Society for Vascular Surgery Terms and Conditions
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Fig 1 Schematic view of the surgical techniques. Left, Traditional radial-cephalic construction (control group). Right, The radial artery deviation and reimplantation (RADAR) technique; only one aspect of the vein is dissected to perform the anastomosis, and the radial artery is deviated with its pedicle (artery and two veins). Journal of Vascular Surgery , e1DOI: ( /j.jvs ) Copyright © 2016 Society for Vascular Surgery Terms and Conditions
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Fig 2 Flow chart summarizing historical control and radial artery deviation and reimplantation (RADAR) group selection. AVF, Arteriovenous fistula. Journal of Vascular Surgery , e1DOI: ( /j.jvs ) Copyright © 2016 Society for Vascular Surgery Terms and Conditions
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Fig 3 Kaplan-Meier curves and Breslow analysis for comparison between the radial artery deviation and reimplantation (RADAR) group and the historical control group. A, Estimation of the overall survival (P = .90). B, Estimation of the primary patency (P < ). C, Estimation of the secondary patency (P = .0003). D, Estimation of the cumulative rate of reintervention in the juxta-anastomotic segment (P = .0002). Journal of Vascular Surgery , e1DOI: ( /j.jvs ) Copyright © 2016 Society for Vascular Surgery Terms and Conditions
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Fig 4 Evaluation of fistula maturation in radial artery deviation and reimplantation (RADAR) access. A, Venous diameter. B, Arterial diameter. C, Access flow. The blocks represent 95% confidence interval (CI). The bars represent minimal and maximal values. *P < compared with 3-week measurement (one-way analysis of variance and Bonferroni post hoc analysis). D, Representative color duplex ultrasound image of the outflow vein. Alternating colors show spiral flow in the RADAR fistulas. Journal of Vascular Surgery , e1DOI: ( /j.jvs ) Copyright © 2016 Society for Vascular Surgery Terms and Conditions
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