scholarly journals Plication as Primary Treatment of Steal Syndrome in Arteriovenous Fistulas

2009 ◽  
Vol 50 (1) ◽  
pp. 233-234
Author(s):  
A. Yaghoubian ◽  
C. de Virgilio
Keyword(s):  
Primary Treatment ◽  
Arteriovenous Fistulas ◽  
Steal Syndrome

Plication as Primary Treatment of Steal Syndrome in Arteriovenous Fistulas

2009 ◽  
Vol 23 (1) ◽  
pp. 103-107 ◽  
Author(s):  
Arezou Yaghoubian ◽  
Christian de Virgilio
Keyword(s):  
Primary Treatment ◽  
Arteriovenous Fistulas ◽  
Steal Syndrome

Plication as Primary Treatment of Steal Syndrome in Arteriovenous Fistulas

2009 ◽  
Vol 2009 ◽  
pp. 207-209
Author(s):  
G.L. Moneta
Keyword(s):  
Primary Treatment ◽  
Arteriovenous Fistulas ◽  
Steal Syndrome

Simple and Durable Resolution of Steal Syndrome by Conversion of Brachial Artery Arteriovenous Fistulas to Proximal Radial Artery Inflow

2010 ◽  
Vol 11 (4) ◽  
pp. 352-355 ◽  
Author(s):  
Brett A. Beecher ◽  
Kevin E. Taubman ◽  
William C. Jennings
Keyword(s):  
Radial Artery ◽  
Brachial Artery ◽  
Arteriovenous Fistulas ◽  
Steal Syndrome

scholarly journals Distal Revascularisation with Interval Ligation (DRIL): An Experience

2009 ◽  
Vol 91 (5) ◽  
pp. 394-398 ◽  
Author(s):  
M Field ◽  
J Blackwell ◽  
A Jaipersad ◽  
M Wall ◽  
MA Silva ◽  
...  
Keyword(s):  
Vascular Access ◽  
International Studies ◽  
Rest Pain ◽  
Basilic Vein ◽  
Central Lines ◽  
Arteriovenous Fistulas ◽  
Number Of Patients ◽  
Digital Pulse ◽  
Global Increase ◽  
Steal Syndrome

INTRODUCTION The global increase of chronic renal failure has resulted in a growing number of patients on haemodialysis using arteriovenous fistulas (AVFs). By virtue of their very function, AVFs at times shunt blood away from regions distally, resulting in an ischaemic steal syndrome. Distal revascularisation with interval ligation (DRIL) has been described as a procedure to treat symptomatic ischaemic steal. We present our experience in the management of this complication. PATIENTS AND METHODS Six patients with severe ischaemic steal were treated using a DRIL procedure between May 2004 and June 2007. There were three males and three females, all with elbow brachiocephalic AVFs. Symptoms ranged from severe rest pain to digital gangrene. Published results from international studies of 135 DRIL procedures were also reviewed. RESULTS Vascular access was maintained along with the elimination of ischaemic symptoms in the six patients using an ipsilateral reversed basilic vein graft. Interval ligation of the distal brachial artery was performed at the same time. All patients showed immediate and sustained clinical improvement of symptoms with a demonstrable increase in digital pulse oximetry. CONCLUSIONS DRIL is a beneficial treatment option that has proven successful at alleviating ischemic steal symptoms and preserving vascular access. This avoids placement of central lines, its associated risks, and the need to create an alternative sited fistula.

A systematic review of the brachial vein arteriovenous fistulas as a viable option for haemodialysis access

2020 ◽  
pp. 112972982098317
Author(s):  
Paschalis Gavriilidis ◽  
Vassilios Papalois
Keyword(s):  
Systematic Review ◽  
Patency Rate ◽  
Secondary Patency ◽  
Viable Option ◽  
Arteriovenous Fistulas ◽  
Secondary Patency Rate ◽  
Pseudo Aneurysm ◽  
Brachial Vein ◽  
Secondary Outcomes ◽  
Steal Syndrome

Objectives: International guidelines recommend the use of autogenous vascular access. Where suitable superficial veins are unavailable deeper veins may be used as an option. In most cases, basilic veins are used when cephalic veins are unavailable; arteriovenous fistulas using the brachial vein from the deep venous network are rare. Therefore, the purpose of the present study was to conduct a systematic review of the available literature evaluating the use of the brachial vein in arteriovenous fistulas. Methods: Systematic literature search of electronic databases in accordance with PRISMA was conducted. The primary outcomes of this study were primary and secondary patency rates for brachial vein arteriovenous fistulas; the secondary outcomes were the rates of access thrombosis, steal syndrome, pseudo-aneurysm and infection. Results: The 1-year primary, assisted, and secondary patency was recorded at (24%–77%), (45%–85%) and (45%–96%), respectively. The 2-year primary, assisted and secondary patency rate was recorded at (12%–46%), (19%–75%) and (19%–92%), respectively. However, the consistency regarding the reports and definitions used were highly variable. The incidence rate of infection, thrombosis and steal syndrome was 5% (0%–12%), 15.9% (9.5%–35%) and 3% (2%–6%), respectively. Conclusion: Available studies support the use of brachial veins as a reliable access option in patients with non-accessible superficial veins where an autologous option is required.

Transylvian Clip Occlusion of an Enlarging High-Flow Tentorial Arteriovenous Fistula: 2-Dimensional Operative Video

2019 ◽  
Vol 19 (2) ◽  
pp. E172-E173 ◽  
Author(s):  
Salomon Cohen-Cohen ◽  
Michael J Link ◽  
Leonardo Rangel-Castilla
Keyword(s):  
Indocyanine Green Angiography ◽  
Venous Drainage ◽  
Transverse Sinus ◽  
Primary Treatment ◽  
High Flow ◽  
Arteriovenous Fistulas ◽  
Surgical Access ◽  
Dural Arteriovenous Fistulas ◽  
Clip Occlusion ◽  
Neurologically Intact

Abstract Endovascular therapy is the primary treatment for the majority of tentorial dural arteriovenous fistulas (dAVF). Surgical occlusion is an effective alternative when embolization is not possible. This video demonstrates microsugical occlusion of a right-sided tentorial dAVF in a symptomatic 45-yr-old male. The dAVF was fed directly by meningohypophyseal trunk. Venous drainage was retrograde through the sphenoparietal sinus, superficial sylvian vein, vein of Labee, and transverse sinus. The patient underwent a right-sided pterional craniotomy; the sylvian fissure was widely opened. Subarachoid dissection was performed until a large arterialized draining vein was identified exiting dura subtemporally. Intraoperative indocyanine green angiography confirmed the fistulous site and the draining vein was occluded and divided. The patient remained neurologically intact after surgery. Immediate angiography demonstrates complete occlusion of the dAVF. This video demonstrates the surgical access obtained through a transylvian approach for this tentorial dAVF. Occlusion of the draining vein, with or without resection of the fistula, is enough to permanently treat these lesions.

scholarly journals A modified banding technique: experience of a center

2020 ◽  
Author(s):  
Sofia S. G. Cerqueira ◽  
Joana M. Ferreira ◽  
Mónica R. Fructuoso ◽  
Catarina Eusebio ◽  
Rui A. Castro ◽  
...  
Keyword(s):  
Patency Rate ◽  
Surgical Techniques ◽  
Primary Patency ◽  
High Flow ◽  
Viable Alternative ◽  
Banding Technique ◽  
Free Access ◽  
Primary Patency Rate ◽  
Arteriovenous Fistulas ◽  
Steal Syndrome

ABSTRACT Background: A well-functioning vascular access is vital to patients on regular hemodialysis. Banding the access is indicated in high-flow-associated steal syndrome. It allows for the reduction of access flow while maintaining distal limb perfusion. Nonetheless, this procedure has some limitations as it can cause hemorrhage, infection, aneurysm formation, thrombosis of access in cases of overbanding, or otherwise insufficient reduction of vascular flow. Other surgical techniques to achieve the same benefit would be useful. Methods: We performed a modified banding technique without endovascular placement of the angioplasty balloon, which is a viable alternative to other techniques. This surgery was performed in patients on chronic dialysis with steal syndrome. Pre- and post-operative access flows were measured and resolution of symptoms was recorded. Primary patency rate was defined as the intervention-free access survival from the operative time. Results: We verified that this technique allowed for access flow reduction in all our six patients, with total resolution of symptoms in all patients. Primary patency rate at 12 months was 100%. No major complications were noted during our follow-up. Conclusions: This technique allows for correction of high-flow arteriovenous fistulas in an efficient and safe way, and can be a viable alternative to other banding procedures.

Stenting for chronic venous obstructions a new era

2013 ◽  
Vol 28 (1_suppl) ◽  
pp. 117-122 ◽  
Author(s):  
R De Graaf ◽  
C Arnoldussen ◽  
C H A Wittens
Keyword(s):  
Bypass Surgery ◽  
Imaging Techniques ◽  
Primary Treatment ◽  
Lessons Learned ◽  
Stent Design ◽  
New Era ◽  
Arteriovenous Fistulas ◽  
Endovascular Approach ◽  
Technical Considerations

Chronic iliocaval venous obstructions have been treated by means of bypass surgery until endovascular treatment emerged as a valuable alternative. With the introduction of new imaging modalities, recanalization techniques and novel stent design the endovascular approach gained even more popularity and surpassed surgery as the primary treatment option. Still, lessons learned from our and others' experience launches a new era in which we should decide on some unsolved issues. Foremost, reproducible imaging techniques should help to define treatment indication. Second, further research is needed to establish the optimal stent design, but also advice on stenting techniques. Finally, if and when arteriovenous fistulas should be used to support early patency is still unclear. This manuscript addresses some of these technical considerations, pitfalls and complications to advice on materials and methods to optimize the quality of your treatment.

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