Showing papers by "Jan H.M. Tordoir published in 1998"

Does pre-operative duplex examination improve patency rates of Brescia-Cimino fistulas?

Abstract: A well-functioning vascular access remains the lifeline for patients with end-stage renal failure, who are being treated by chronic haemodialysis. Since 1966, the radiocephalic arteriovenous (AV) fistula, initially described by Brescia and Cimino, has been employed as a vascular access in many dialysis patients [1]. The Brescia-Cimino AV fistula has a low rate of complications and a high patency rate. Usually, the successful creation of this type of AV fistula depends on the quality and diameter of the radial artery and cephalic vein at the level of the wrist. Before the AV fistula actually can be punctured and is able to deliver a sufficient amount of blood to the artificial kidney, a certain period of time (usually 3-6 weeks) is needed for so-called fistula maturation. During this time period, a substantial increase in blood flow and vessel dilatation must occur. The chance of a successful maturation is difficult to predict and depends on the ability of the arterial and venous vessels to dilate under the influence of the increased shear rates (vessel remodelling). Major negative factors determining vessel quality are diabetes mellitus, older age and also the number of previous infusions, which may harm cephalic vein continuity.

Effects of Surgical Sympathectomy on Skin Blood Flow in a Rat Model of Chronic Limb Ischemia

Abstract: p < 0.05), NSBF ( p < 0.05), and SO ( p < 0.05) were found to be drastically reduced at day 2 after ligation compared to preligation values. This reduction partially recovered during the following weeks. TSBF ( p < 0.05) and NSBF ( p < 0.05), however were still reduced at day 28 after ligation compared to preligation values, whereas the SO at this time tended to be lower ( p = 0.11). In the sympathectomy group the TSBF was found to be increased at day 2 ( p < 0.05) and day 28 ( p < 0.05) after sympathectomy, both compared to values obtained at day 28 after ligation. Sympathectomy did not have an effect on NSBF and SO. The sham procedure had no effect on the TSBF, NSBF, or SO. These results indicate that in case of lower limb ischemia, sympathectomy improves skin blood flow at the thermoregulatory but not the nutritive level of skin microcirculation. This may be related to the fact that the thermoregulatory vessels are mainly sympathetically controlled, whereas the nutritive capillaries are mainly controlled by local (nonneural) factors.