{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T21:07:31Z","timestamp":1771708051551,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,3,4]],"date-time":"2013-03-04T00:00:00Z","timestamp":1362355200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Seminars in Dialysis"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Cephalic arch lesions are common cause for dysfunction of brachiocephalic arteriovenous fistulas. For lesions resistant or not amenable to endovascular interventions, we used a term \u201ccephalic arch occlusive lesions\u201d (<jats:styled-content style=\"fixed-case\">CAO<\/jats:styled-content>) that included cephalic arch total occlusion, frequently recurrent stenosis (requiring angioplasty in &lt;3\u2010month intervals), high\u2010grade elastic stenosis (residual stenosis &gt;50% after angioplasty), or other lesions not amenable to endovascular interventions. Herein, we report 40 patients who underwent surgical revisions for total occlusions (17\/40), frequently recurrent stenosis (17\/40), high\u2010grade elastic stenosis (5\/40), and zigzag stenosis (1\/40). The revisions included cephalic transposition and venovenostomy (<jats:styled-content style=\"fixed-case\">CTV<\/jats:styled-content>\u00a0=\u00a037\/40), basilic transposition and venovenostomy (1\/40), stenotic segment resection (1\/40), and cephalic\u2010jugular vein bypass graft (1\/40). At 12\u2010month post\u2010<jats:styled-content style=\"fixed-case\">CTV<\/jats:styled-content>, the primary patency of the transposed cephalic vein, the fistula assisted primary and secondary patency rates were 25%, 82% and 97%, respectively. Notably, pre\u2010<jats:styled-content style=\"fixed-case\">CTV<\/jats:styled-content> angioplasty of the proximal cephalic vein was the only significant predictor for the low primary patency rate (hazard ratio 4.5, <jats:italic>p\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.002). Accordingly, the primary patency rates were 12% and 58% in patients with and without pre\u2010<jats:styled-content style=\"fixed-case\">CTV<\/jats:styled-content> angioplasty, respectively. In summary, surgical interventions are effective in salvaging fistulas complicated with <jats:styled-content style=\"fixed-case\">CAO<\/jats:styled-content>. Importantly, pre\u2010<jats:styled-content style=\"fixed-case\">CTV<\/jats:styled-content> angioplasty of the proximal cephalic vein might adversely affect the outcome of <jats:styled-content style=\"fixed-case\">CTV<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/sdi.12085","type":"journal-article","created":{"date-parts":[[2013,3,5]],"date-time":"2013-03-05T10:31:54Z","timestamp":1362479514000},"source":"Crossref","is-referenced-by-count":22,"title":["Surgical Management of Cephalic Arch Occlusive Lesions: Are There Predictors for Outcomes?"],"prefix":"10.1111","volume":"26","author":[{"given":"Shouwen","family":"Wang","sequence":"first","affiliation":[{"name":"AKDHC\u2010ASC Arizona Kidney Disease and Hypertension Center Phoenix Arizona"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ammar","family":"Almehmi","sequence":"additional","affiliation":[{"name":"University Vascular Access Center University of Tennessee College of Medicine Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arif","family":"Asif","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Albany Medical College Albany New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,3,4]]},"reference":[{"issue":"1","key":"e_1_2_8_2_1","first-page":"S176","article-title":"Clinical practice guidelines for vascular access","volume":"48","author":"NKF\u2010KDOQI","year":"2006","journal-title":"Am J Kidney 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