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Abstract
Patients with chronic renal failure and vascular diseases require the vascular access for hemodialysis procedure to be performed with the most possible comfort for the patient. Native vein graft has a longer-lasting term in the patients' limb, lower risk of graft infection and lower price. Native vein graft is constructed from the great saphenous vein, if the diameter of the vessel is smaller than the diameters of vessels (brachial artery, cephalic vein) it is connected to the cubital fossa region due to the risk of graft folding, that might occur, if the graft diameter is bigger than the diameter of one or both vessels, on which anastomosis is made. The most important sizes, that were taken before graft placement, are the length of the forearm compartment, the distance between the brachial artery and cephalic vein in the cubital fossa region, distance from an expected incision in the brachial artery to the middle of the forearm compartment, the distance between incision in cephalic vein to the middle of the forearm compartment, length of the great saphenous vein (the graft) and diameters of blood vessels, used in the procedure. Finally, the right position of the graft should be determined for the successful outcome of anastomosis creating procedure.
Keywords
Arteriovenous graft, hemodialysis, vascular access, anastomosis.
1.Introduction
The arteriovenous graft is a type of vascular access. For the graft insertion most, preferred places are arm or forearm with the most often chosen blood vessels - the brachial artery and cephalic or basilic vein, or lower limb, where the femoral artery and femoral vein are chosen for arteriovenous connection [24]. Left or right extremity is chosen, depending on patient comfort (right-handed, left-handed), anamnesis (vascular diseases, emboly, previous surgeries). The graft is recommended for nephrology department patients with chronic renal failure, which is one of the most prevalent worldwide public health problems in the field of nephrology, that affects functions of the kidney. Some of the curing methods for chronic renal failure are kidney transplantation, hemodialysis or peritoneal dialysis [27]. While the patient is waiting for the kidney donor, he/she needs to be undergoing a hemodialysis procedure. The arteriovenous graft is a frequent procedure in the hemodialysis unit due to easier access to blood vessels, which lets the medical...