Fogarty® catheter dilatation of veins smaller than 2.5 mm after completion of the anastomosis during arteriovenous fistula creation

Introduction. Risk of failure after surgical creation of the AVF was linked to the diameter and flow dynamics of the vessel that is to be quantified by preoperative ultrasound mapping. We aimed to report our results using a different technique consisting of Fogarty® catheter dilatation of the cephalic vein after completion of the anastomosis. Material and methods. A total of 23 patients, aged between 35 to 70 years, with a cephalic vein diameter of ≤ 2.5 mm received a dilatation technique for arteriovenous creation. Patients having reoperations, aneurysmatic or thrombosed veins and multiple risk factors were not considered eligible and access failure within 60 days was defined as early fistula failure. Results. Mean cephalic vein diameter was 2.03 ± 0.28 mm and mean radial artery diameter was 2.33 ± 0.16 mm. At 15th day visit, 21 of 23 patients (91.3%) had patent arteriovenous fistula. Mean time of follow-up was 7.2 ± 1.67 months and was complete in 20 of 21 patients with a patent fistula. Overall patency was 18/23 (78.2%) in patients with survived AVFs. Conclusion. Fogarty® catheter dilatation of the cephalic vein after completion of the anastomosis during arteriovenous fistula creation is effective and safe in patients with small calibrated veins

Sacralization may be associated with facet orientation and tropism but not degenerative changes of the lumbar vertebrae

Purpose: In this retrospective study, we aimed to investigate the possible effects of transitional vertebra anatomy on facet joint tropism and orientation by evaluating lumbar magnetic resonance imaging (MRI) studies performed at our institution. Material and methods: We included 84 patients with sacralization of the L5 vertebra and an equal number of patients with a radiology report within normal limits as the control group in our study. We compared facet tropism (FT) and orientation between both groups. Results: In both the sacralization group and the control group, the facet orientation angle showed a significant increasing trend from the L1-L2 level to the L5-S1 level (p < 0.001). The orientation angle of the L5-S1 level was higher in the sacralization group compared to the control group (p < 0.01). In the evaluation of FJ orientation between the sacralization and control groups, we found that coronal orientation was significantly more frequent at the L5-S1 level in the sacralization group. When the 2 groups were compared with regard to tropism at each spinal level, the sacralization group had a significantly higher FT frequency at the L5-S1 level (p < 0.001). Conclusions: To our knowledge, this is the first study to evaluate the relationship between sacralization and facet joint tropism. However, there were no relationships between facet degeneration, disc degeneration/herniation, and sacralization. Our results indicate that, although patients with sacralization and controls had similar characteristics in most assessments, they demonstrated significant differences at the L5-S1 level in terms of orientation and tropism