SciCombinator

Discover the most talked about and latest scientific content & concepts.

Concept: Basilic vein

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The care and outcome of patients with end stage renal disease (ESRD) on chronic hemodialysis is directly dependent on their hemodialysis access. A brachiocephalic fistula (BCF) is commonly placed in the elderly and in patients with a failed lower-arm, or radiocephalic, fistula. However, there are numerous complications such that the BCF has an average patency of only 3.6 years. A leading cause of BCF dysfunction and failure is stenosis in the arch of the cephalic vein near its junction with the axillary vein, which is called cephalic arch stenosis (CAS). Using a combined clinical and computational investigation, we seek to improve our understanding of the cause of CAS, and to develop a means of predicting CAS risk in patients with a planned BCF access. This paper details the methodology used to determine the hemodynamic consequences of the post-fistula environment and illustrates detailed results for a representative sample of patient-specific anatomies, including a single, bifurcated, and trifurcated arch. It is found that the high flows present due to fistula creation lead to secondary flows in the arch owing to its curvature with corresponding low wall shear stresses. The abnormally low wall shear stress locations correlate with the development of stenosis in the singular case that is tracked in time for a period of one year.

Concepts: Chronic kidney disease, Dialysis, Force, Shear stress, Artificial kidney, Axillary vein, Cephalic vein, Basilic vein

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Venous punctures are among the most common procedures performed by healthcare professionals. In particular, the cubital fossa is the site where the venous accesses are frequently made due to the number of superficial veins and the numerous anastomoses in this region. The arrangement of these venous connections is of particular interest for clinical application in several areas, thus, the healthcare professional must possess knowledge about these vessels and their anatomical relationships. The present study aims to analyze the venous pattern of the cubital fossa among individuals from Brazil. This study was approved by a Research Ethics Committee. The sample had 100 healthy individuals (50 men and 50 women). The superficial veins of the cubital fossa were analyzed with the aid of a sphygmomanometer. When inflated, the pressure in the forearm increased and the veins became prominent. It was observed that in the selected sample the types with the highest prevalence were the Type I and Type VII, both with 22% in 200 limbs studied. The chi2test showed a significant statistical difference between the anastomosis pattern and the sex of the studied sample. The anastomotic pattern of the superficial veins of the studies sample is similar to African, European and Asian populations. The study of these variations is necessary to provide scientific basis for the healthcare professional during a venipuncture in order to avoid iatrogenic errors and damages in cutaneous nerves or neighboring arteries.

Concepts: Blood, Blood vessel, Blood pressure, Vein, Cardiovascular system, Anastomosis, Median cubital vein, Basilic vein

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Subcutaneous masses along the cubital fossa can be a diagnostic dilemma. Most patients are asymptomatic and usually present for a cosmetic reason. Diagnosis can be confirmed by radiological findings and histopathology. We present a case report of a similar mass that turned out to be a haemangioma arising from the basilic vein with brief review of literature.

Concepts: Medical terms, Greek loanwords, Differential diagnosis, Superficial vein, Dorsal venous network of hand, Cubital fossa, Median cubital vein, Basilic vein

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Basilic vein transposition via single long incision is a renowned technique despite its known wound related complications. Contrary to that, multiple skip incisions technique is thought to have relatively lower wound related complications. But to the best of our knowledge these two techniques have never been formally compared. So we conducted this study to compare both.

Concepts: Cohort study, Cognition, Learning, Arteriovenous fistula, Greatest hits, Superficial vein, Dorsal venous network of hand, Basilic vein

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The proximal cephalic vein that enters the axillary vein (cephalic arch) is a common site of stenosis in patients with upper extremity arteriovenous fistulas for hemodialysis (HD). In this study, we present the outcomes of a series of cephalic vein transposition, to determine its utility in the setting of refractory arch stenosis.

Concepts: Arteriovenous fistula, Upper limb, Axillary artery, Axillary vein, Dorsal venous network of hand, Cephalic vein, Basilic vein, Veins of the upper limb

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The cephalic vein arises from the radial end of the dorsal venous arch. It turns around the radial border of the forearm and passes proximally along the arm to the shoulder, where it enters the axillary vein by penetrating the clavipectoral triangle. The cephalic vein is prone to vary at the antecubital fossa, where it forms numerous anastomoses. A male cadaver fixated with a 10% formalin solution was dissected during regular anatomy lessons. It was found that the cephalic vein crossed the upper third of the arm between two fasciculi of the deltoid muscle and reached the shoulder, where it passed above the acromion and crossed the posterior border of the clavicle in order to join the external jugular vein. The cephalic vein is one of the most used veins for innumerous activities, such as venipunctures and arteriovenous fistula creation. Furthermore, it is an anatomical landmark known for its consistent anatomy, as it possesses low rates of variability. Despite that, its anatomical variations are clinically and surgically significant and healthcare professionals must be aware of the variations of this vessel. We aim to report a rarely described variation of the cephalic vein and discuss its embryological, phylogenetic and clinical features.

Concepts: Anatomy, Shoulder, Subclavian vein, Deltoid muscle, Clavicle, Dorsal venous network of hand, Cephalic vein, Basilic vein

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Basilic vein transposition (BVT) fistulas may be performed as either a one-stage or two-stage operation, although there is debate as to which technique is superior. This study was designed to evaluate the comparative clinical efficacy and cost-effectiveness of one-stage vs two-stage BVT.

Concepts: Clinical trial, Effectiveness, Arteriovenous fistula, Superficial vein, Dorsal venous network of hand, Basilic vein

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Transposed basilic vein arteriovenous fistulas suffer from stenosis at their basilic angle of transposition (BAT). This lesion exhibits frequent recurrence after angioplasty. The primary goal of this study was to determine the effect of stent-graft placement on BAT lesion- and access-patency. The secondary goals were to determine the frequency of intervention pre- and post-stent placement and stent-associated stenosis.

Concepts: Stent, Arteriovenous fistula, Fistula, Superficial vein, Axillary vein, Goal, Dorsal venous network of hand, Basilic vein

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If a transfemoral approach for catheter ablation procedures of paroxysmal supraventricular tachycardias is impossible, other access sites have to be considered. We present the case of a 78-year-old woman with an inferior vena cava (IVC) filter with symptomatic episodes of an atrioventricular nodal reentrant tachycardia (AVNRT). We used a combined cubital and axillary vein approach. The tachycardia was successfully ablated within the timeframe needed for conventional ablation.

Concepts: Cardiac electrophysiology, Supraventricular tachycardia, Inferior vena cava, Superior vena cava, Tachycardia, AV nodal reentrant tachycardia, Basilic vein

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Axillary vein access for pacemaker implantation is uncommon in many centres because of the lack of training in this technique. We assessed whether the introduction of the axillary vein technique was safe and efficient as compared with cephalic vein access, in a centre where no operators had any previous experience in axillary vein puncture.

Concepts: Introduction, Axillary artery, Axillary vein, Dorsal venous network of hand, Cephalic vein, Basilic vein, Veins of the upper limb