Document 1021
 DOCN  M94A1021
 TI    Arteriovenous fistulae for chronic vascular access in pts. with AIDS.
 DT    9412
 AU    Greene JB; Giangola G; Salik JM; Walsh I; Felice JA; Ratkewich M; NYU
       Medical Center.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(2):227 (abstract no. PB0922). Unique
       Identifier : AIDSLINE ICA10/94371554
 AB    OBJECTIVE: Patients with advanced AIDS frequently require chronic
       vascular access for the administration of various antimicrobial agents.
       Subcutaneous port systems and percutaneous/tunnelled catheters have a
       high rate of infection, thrombosis, and catheter failure/migration. We
       sought to evaluate the utility of surgically created arterio-venous
       fistulae as a chronic vascular access alternative. METHODS: Because of
       multiple/recurrent Hickman catheter infections in two patients, and a
       chronic dermatosis predisposing to infection in a third patient, chronic
       vascular access was accomplished by the surgical creation of an upper
       extremity arterio-venous fistula. RESULTS: No surgical complications
       were observed and excellent venous arcades were ready for accessing
       within two weeks after surgery. Patients were taught to self-access
       their veins with small-bore butterfly needles and were successful in
       maintaining their therapies [ganciclovir (2), foscarnet (1)] without
       infection, fistula failure or other complications. Patient selection
       guidelines, clinical follow-up and comparative retrospective data from a
       national catheter registry will be presented. CONCLUSIONS: Surgical
       arterio-venous fistulae represent a potential alternative to indwelling
       catheters for chronic vascular access in selected patients with AIDS.
 DE    Acquired Immunodeficiency Syndrome/*SURGERY  *Arteriovenous Shunt,
       Surgical  Human  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).