Applying theno-touch technique to venous dissection for the construction of the autogenous arteriovenous fistula in patients with maintenance hemodialysis

Studies have found that, the vascular injury caused by venous dissection during the construction of the autogenous arteriovenous fistula (AVF) in patients with maintenance hemodialysis (MHD) canresulted in venous intimal hyperplasia and stenosis of the AVF, by activating perivascular fibroblasts, initiating the inflammatory response of the perivascular membrane and damaging the venous vasa vasorum, so as to lead to the dysfunction of the AVF. When applying the saphenous vein tothe coronary artery bypass surgery (CABG), Souza et alproposed the no-touch technique (NTT)for vein dissection. Comparing with the conventional technique (CT) for vein dissection, NTT can reduce the vascular injury caused by the process of vein dissection and improve the postoperative patency rate of the vein graft. In recent years, NTT has been applied to venous dissection for the construction of the AVF in MHD patients, thus to provide a novel surgical method for improving the postoperative patency rate of the AVF. This article will reviews the mechanism how NTT for venous dissection and construction of AVF canimprove the postoperative patency rate of the AVF.