Abstract
In order to expand the availability of sources for vascular access. The feasibility and safety of the superficialization of the radial artery was studied. Prior to the surgery, the bore and severity of arteriosclerosis of the radial artery were examined with ultrasound tomography. An incision was made medial to the radial artery of the forearm in order to avoid damaging the lateral cutaneous nerve. Then, subcutaneous tissue was exfoliated carefully to reach the fascia. Finally, the radial artery was dissected in the space between the flexor carpi radialis and brachioradial muscles. Throughout the procedure, care was taken not to injure the superficial branch of a radial nerve which is running closely with the radial artery on its lateral side. After arterial dissection, the fascia was sutured to form the posterior wall. The procedure was completed by attaching the artery to the skin. Superficialization of the radial artery was performed safely in 5 cases (age: 58～90, male: 4, female: 1) including 2 primary cases with heart failure. In 2 cases, radial artery superficialization was performed as a backup access for ordinary arteriovenous fistula reconstruction. One case did not have a suitable vein in the forearm, and blood was drawn from a superficalized radial artery and returned to the vein of the fossa cubitalis. In 3 cases, the constructed vascular access provided sufficient blood flow (>250 mL/min) for stable hemodialysis. Superficialization of a radial artery can be a useful alternative for the construction of vascular access for hemodialysis.
